scholarly journals Prevalence and Incidence of Antimicrobial-Resistant Organisms among Hospitalized Inflammatory Bowel Disease Patients

2013 ◽  
Vol 24 (4) ◽  
pp. e117-e121 ◽  
Author(s):  
Alon Vaisman ◽  
Kevin Pivovarov ◽  
Allison McGeer ◽  
Barbara Willey ◽  
Bjug Borgundvaag ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Antibiotic Use ◽  
Time Interval ◽  
Methicillin Resistant ◽  
Extended Spectrum Beta Lactamase ◽  
Vancomycin Resistant Enterococci ◽  
Immunosuppressive Medications ◽  
Inflammatory Bowel ◽  
Vancomycin Resistant

BACKGROUND: Patients with inflammatory bowel disease (IBD) experience frequent hospitalizations and use of immunosuppressive medications, which may predispose them to colonization with antimicrobial-resistant organisms (ARO).OBJECTIVE: To determine the prevalence of ARO colonization on admission to hospital and the incidence of infection during hospitalization among hospitalized IBD patients.METHODS: A chart review comparing the prevalence of colonization and incidence of infection with methicillin-resistantStaphylococcus aureus, vancomycin-resistant enterococci and extended-spectrum beta-lactamase-producingEnterobacteriaceae(ESBL) in hospitalized IBD patients with those of non-IBD controls was performed.RESULTS: On admission, there were no significant differences between IBD inpatients and controls in the prevalence of colonization of methicillin-resistantS aureus(1.0% versus 1.2%; P=0.74), vancomycin-resistant enterococci (0.2% versus 0%; P=1.0) or ESBL (4.1% versus 5.5%; P=0.33). Pooling data from historical clinic-based cohorts, IBD patients were more likely than controls to have ESBL colonization (19% versus 6.6%; P<0.05). Antibiotic use on admission was associated with ESBL colonization among IBD inpatients (OR 4.2 [95% CI 1.4 to 12.6]). The incidence of ARO infections during hospitalization was not significantly different between IBD patients and controls. Among IBD patients who acquired ARO infections during hospitalizations, the mean time interval from admission to infection was shorter for those who were already colonized with ARO on admission.CONCLUSIONS: This particular population of hospitalized IBD patients was not shown to have a higher prevalence or incidence of ARO colonization or infection compared with non-IBD inpatients.

Effectiveness of Conjugate and Polysaccharide Pneumococcal Vaccines for Prevention of Severe Pneumococcal Disease Among Inflammatory Bowel Disease Patients

2021 ◽  
Author(s):  
Bryan L Love ◽  
Christopher J Finney ◽  
Jill K J Gaidos
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Cox Proportional Hazards Model ◽  
Health Administration ◽  
Immunosuppressive Medications ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background Streptococcus pneumoniae is an important pathogen responsible for severe pneumococcal diseases, including pneumonia, bacteremia/sepsis, and meningitis. Inflammatory bowel disease (IBD) patients have an increased risk for infections due to an altered immune system and treatment with immunosuppressive medications. The aim of this study was to assess the prevalence of severe pneumococcal disease (SPD) and evaluate the impact of pneumococcal vaccination on the risk of SPD in Veterans with IBD. Methods Subjects with IBD and SPD were identified from the VA Health Administration database using ICD9/10 codes. Pneumococcal vaccination and use of immunosuppressant medications were collected. Risk of SPD was evaluated using an adjusted Cox proportional hazards model controlling for demographics, medications, vaccination, and comorbidities. Results A total of 1798 cases of SPD were identified (283 pneumonia, 1,513 bacteremia, and 2 meningitis). SPD patients were older (60.9 years vs 59.4 years; p&lt;0.001), had more comorbidities (Charlson Comorbidity Index of 2.11 vs. 0.96; p&lt;0.001) and had increased mortality (4.6% vs. 1.5%, p&lt;0.001). The risk of SPD was increased in Crohn’s disease (HR 1.15; 95% CI 1.05-1.27) and with more comorbidities (HR 1.45; 95% CI 1.42-1.48). Use of immunosuppressive medications increased the risk of SPD. Receipt of PCV13 either alone or in combination with PPSV23 predicted a five-fold decreased risk of SPD compared with no vaccination. Conclusion Vaccination with PCV13 alone or in combination with PPSV23 and revaccination with PPSV23, was protective against SPD. All IBD patients should be evaluated for pneumococcal vaccination, particularly those receiving or expected to receive immunosuppressive therapies.

scholarly journals Perinatal and Antibiotic Exposures and the Risk of Developing Childhood-Onset Inflammatory Bowel Disease: A Nested Case-Control Study Based on a Population-Based Birth Cohort

2020 ◽  
Vol 17 (7) ◽  
pp. 2409 ◽  
Author(s):  
Cristina Canova ◽  
Jonas F Ludvigsson ◽  
Riccardo Di Domenicantonio ◽  
Loris Zanier ◽  
Claudio Barbiellini Amidei ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Birth Cohort ◽  
Bowel Disease ◽  
Antibiotic Use ◽  
Case Control ◽  
Childhood Onset ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Nested Case Control ◽  
The Impact

The role of early-life environmental exposures on Inflammatory Bowel Disease (IBD) onset remains unclear. We aimed to quantify the impact of perinatal conditions and antibiotic use in the first 6 and 12 months of life, on the risk of childhood-onset IBD, in a birth cohort of the region Friuli-Venezia Giulia (Italy). A nested case-control design on a longitudinal cohort of 213,515 newborns was adopted. Conditional binomial regression models were used to estimate Odds Ratios (OR) with 95% confidence intervals (CI) for all analyzed risk factors. We identified 164 individuals with IBD onset before the age of 18 years and 1640 controls. None of the considered perinatal conditions were associated with IBD. Analyses on antibiotic exposure were based on 70 cases and 700 controls. Risks were significantly higher for children with ≥4 antibiotic prescriptions in the first 6 and 12 months of life (OR = 6.34; 95%CI 1.68–24.02 and OR = 2.91; 95%CI 1.31–6.45, respectively). This association was present only among patients with Crohn’s disease and those with earlier IBD onset. We found that perinatal characteristics were not associated to IBD, while the frequent use of antibiotics during the first year of life was associated to an increased risk of developing subsequent childhood-onset IBD.

scholarly journals Antibiotic use and the development of inflammatory bowel disease: a national case-control study in Sweden

2020 ◽  
Vol 5 (11) ◽  
pp. 986-995 ◽  
Author(s):  
Long H Nguyen ◽  
Anne K Örtqvist ◽  
Yin Cao ◽  
Tracey G Simon ◽  
Bjorn Roelstraete ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Case Control Study ◽  
Antibiotic Use ◽  
Case Control ◽  
Inflammatory Bowel ◽  
Control Study

scholarly journals Clostridium difficile in Inflammatory Bowel Disease: A Retrospective Study

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
William Gillespie ◽  
Neil Marya ◽  
Julien Fahed ◽  
Gregory Leslie ◽  
Krunal Patel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Retrospective Study ◽  
Clostridium Difficile ◽  
Bowel Disease ◽  
Biologic Therapy ◽  
Antibiotic Use ◽  
Extraintestinal Manifestations ◽  
Chi Squared ◽  
Inflammatory Bowel

Aim. To investigate the epidemiology and risk factors of Clostridium difficile infections (CDI) in patients with inflammatory bowel disease (IBD). Methods. This is a retrospective study of patients diagnosed with IBD. 1006 charts were screened and 654 patients met the inclusion criteria. Patients were divided into 2 cohorts based on the presence of prior diagnosis of CDI. Statistical analysis with Pearson’s chi-squared and two-sample t-test was performed. Results. The incidence of CDI among IBD patients was 6.7%. There was equal prevalence of CDI among Crohn’s disease (CD) (n=21, 49%) and ulcerative colitis (UC) (n=22, 51%). IBD patients acquired CDI at a mean age of 42.7 years, with 56% of infections acquired in the community and only 28% associated with healthcare. Only 30% of IBD patients with CDI had prior antibiotic use, and 16% had prior steroid use. IBD patients were significantly more likely to require biologic therapy (57% versus 37%, p<0.01) and have extraintestinal manifestations of IBD (43% versus 28%, p<0.02). Conclusions. IBD patients are more susceptible to CDI at a younger age and often lack traditional risk factors. IBD patients with at least one CDI were more likely to require biologic therapy and had greater rates of extraintestinal manifestations.

scholarly journals Discontinuation of Immunosuppressive Medications in Children With Inflammatory Bowel Disease on Combination Therapy

2020 ◽  
Vol 71 (6) ◽  
pp. 740-743
Author(s):  
Wael El-Matary ◽  
Matthew W. Carroll ◽  
Jennifer C. Debruyn ◽  
Hien Huynh ◽  
Eytan Wine ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Combination Therapy ◽  
Bowel Disease ◽  
Immunosuppressive Medications ◽  
Inflammatory Bowel

scholarly journals Young Woman with Leg Lesions

2021 ◽  
Vol 2 (5) ◽  
pp. 265-266
Author(s):  
Daniel Finnin
Keyword(s):  
Inflammatory Bowel Disease ◽  
Young Woman ◽  
Bowel Disease ◽  
Lower Leg ◽  
Skin Condition ◽  
Systemic Diseases ◽  
Case Presentation ◽  
Significant Pain ◽  
Immunosuppressive Medications ◽  
Inflammatory Bowel

Case Presentation: The patient was a 33-year-old woman with inflammatory bowel disease presenting for worsening lower leg lesions with significant pain recalcitrant to oral doxycycline. Discussion: Pyoderma gangrenosum is a rare ulcerative skin condition with significant pain that is often associated with other systemic diseases typically treated with immunosuppressive medications aimed at the underlying cause.

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