Patients with IBD at increased risk for opportunistic infections

  • Sheriff MZ & al.
  • Inflamm Bowel Dis
  • 17 Jul 2019

  • International Clinical Digest
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Takeaway

  • Patients with IBD seem particularly susceptible to opportunistic infections (OIs), including many that are vaccine-preventable.

Why this matters

  • Clinicians should make sure patients with IBD have up-to-date vaccinations against diseases such as pneumonia, HPV, and influenza, and monitor them closely for signs of other opportunistic bacterial, fungal, and viral infections.

Study design

  • Researchers studied the health records of patients with Crohn’s disease (CD; n=153,290; 60% women) and ulcerative colitis (UC; n=128,540; 59% women), comparing OI prevalence in these groups with prevalence in patients without IBD.
  • Funding: Crohn’s and Colitis Foundation.

Key results

  • Compared with an OI prevalence of 7% without IBD, OIs were more than twice as likely with:
    • CD:
      • Prevalence, 17.8%;
      • Prevalence ratio (PR), 2.54 (95% CI, 2.51-2.57);
    • UC: 
      • Prevalence, 19.2%;
      • PR, 2.74 (2.71-2.77).
  • The most common OIs (PRs; 95% CIs) in patients with IBD were: 
    • Clostridium difficile:
      • CD: 11.5 (11.1-11.8);
      • UC: 17.2 (16.8-17.7); and
    • Cytomegalovirus:
      • CD: 10.4 (9.4-11.6); 
      • UC: 14.6 (13.2-16.1).

Limitations

  • The study was retrospective and did not track medication use.
  • Some patients with OIs may have been misdiagnosed or misclassified.