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Prevalence and Effect of Intestinal Infections Detected by a PCR-Based Stool Test in Patients with Inflammatory Bowel Disease
Background The advent of PCR-based stool testing has identified a greatly increased number of infectious agents in IBD, but their clinical significance is unknown. Aims To determine the infectious agent prevalence and the clinical significance of these infectious agents in IBD patients. Methods This...
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| Published in: | Digestive diseases and sciences 2020-11, Vol.65 (11), p.3287-3296 |
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| cites | cdi_FETCH-LOGICAL-c414t-a2a7c5a1e0d6d5a33e0af9cdfaee0f3e8e8734b35cd405620e2bbf4197b0862a3 |
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| container_title | Digestive diseases and sciences |
| container_volume | 65 |
| creator | Limsrivilai, Julajak Saleh, Zachary M. Johnson, Laura A. Stidham, Ryan W. Waljee, Akbar K. Govani, Shail M. Gutermuth, Brian Brown, Alexandra M. Briggs, Emily Rao, Krishna Higgins, Peter D. R. |
| description | Background
The advent of PCR-based stool testing has identified a greatly increased number of infectious agents in IBD, but their clinical significance is unknown.
Aims
To determine the infectious agent prevalence and the clinical significance of these infectious agents in IBD patients.
Methods
This cross-sectional study compared the prevalence of GI infections among IBD patients with active and quiescent disease versus healthy controls. Among actively inflamed patients, we compared clinical characteristics, medication use, and disease course between those with positive and negative tests.
Results
Three hundred and thirty-three IBD patients and 52 healthy volunteers were included. The IBD group was divided into active Crohn’s disease (CD,
n
= 113), inactive CD (
n
= 53), active ulcerative colitis (UC,
n
= 128), and inactive UC (
n
= 39). A significantly higher percentage of actively inflamed patients had positive stool tests (31.1%) compared to those with quiescent disease (7.6%,
P
= |
| doi_str_mv | 10.1007/s10620-020-06071-2 |
| format | article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2345504915</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A712936264</galeid><sourcerecordid>A712936264</sourcerecordid><originalsourceid>FETCH-LOGICAL-c414t-a2a7c5a1e0d6d5a33e0af9cdfaee0f3e8e8734b35cd405620e2bbf4197b0862a3</originalsourceid><addsrcrecordid>eNp9kd9rFDEQx4Mo9jz9B3yQgC--bM2P3eztY3utbaHgofU5zGYnNWU3qUmu5R78382yVRDEhCGT5PMdhvkS8pazY85Y-zFxpgSr2ByKtbwSz8iKN62sRKM2z8mKcVVyztUReZXSHWOsa7l6SY4k7za8rBX5uYv4ACN6gxT8QM-tRZNpsPTKZ0zZeRhLOj-64BM9w1xSHGh_oEB32y_VKaRy_ZpDGOlNUVDn6Q6yQ58TfXT5-ywfYZogh3igp-ERR3rmEhbda_LCwpjwzdO5Jt8-nd9sL6vrzxdX25PrytS8zhUIaE0DHNmghgakRAa2M4MFRGYlbnDTyrqXjRlq1pSZoOh7W_Ou7dlGCZBr8mGpex_Dj31pUk8uGRxH8Bj2SQtZNw2rO94U9P2C3papaOdtyBHMjOuTlotOKqHqQh3_gyp7wMmZ4NG68v6XQCwCE0NKEa2-j26CeNCc6dlNvbip2Ryzm6WpNXn31Pa-n3D4I_ltXwHkAqTy5W8x6ruwj8Wy9L-yvwCldama</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2345504915</pqid></control><display><type>article</type><title>Prevalence and Effect of Intestinal Infections Detected by a PCR-Based Stool Test in Patients with Inflammatory Bowel Disease</title><source>Springer Link</source><creator>Limsrivilai, Julajak ; Saleh, Zachary M. ; Johnson, Laura A. ; Stidham, Ryan W. ; Waljee, Akbar K. ; Govani, Shail M. ; Gutermuth, Brian ; Brown, Alexandra M. ; Briggs, Emily ; Rao, Krishna ; Higgins, Peter D. R.</creator><creatorcontrib>Limsrivilai, Julajak ; Saleh, Zachary M. ; Johnson, Laura A. ; Stidham, Ryan W. ; Waljee, Akbar K. ; Govani, Shail M. ; Gutermuth, Brian ; Brown, Alexandra M. ; Briggs, Emily ; Rao, Krishna ; Higgins, Peter D. R.</creatorcontrib><description>Background
The advent of PCR-based stool testing has identified a greatly increased number of infectious agents in IBD, but their clinical significance is unknown.
Aims
To determine the infectious agent prevalence and the clinical significance of these infectious agents in IBD patients.
Methods
This cross-sectional study compared the prevalence of GI infections among IBD patients with active and quiescent disease versus healthy controls. Among actively inflamed patients, we compared clinical characteristics, medication use, and disease course between those with positive and negative tests.
Results
Three hundred and thirty-three IBD patients and 52 healthy volunteers were included. The IBD group was divided into active Crohn’s disease (CD,
n
= 113), inactive CD (
n
= 53), active ulcerative colitis (UC,
n
= 128), and inactive UC (
n
= 39). A significantly higher percentage of actively inflamed patients had positive stool tests (31.1%) compared to those with quiescent disease (7.6%,
P
= < 0.001) and healthy controls (13.5%,
P
= 0.01). In actively inflamed patients, shorter symptom duration and the use of multiple immunosuppressive agents were significantly associated with positive stool tests. Escalation of immunosuppressive therapy was less frequent in those with positive (61.3%) than with negative tests (77.7%,
P
= < 0.01). However, the need for surgery (13.3% vs. 18.7%, respectively,
P
= 0.31) and hospitalization (14.7% vs. 17.5%, respectively,
P
= 0.57) in 90 days was not significantly different.
Conclusion
GI infections are common in IBD patients with active disease. Evaluating patients for infection may help avoid unnecessary escalation of immunosuppressants, especially during an acute flare or combination immunosuppression.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-020-06071-2</identifier><identifier>PMID: 31981111</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Bacterial Infections - epidemiology ; Bacterial Infections - microbiology ; Biochemistry ; Care and treatment ; Case-Control Studies ; Comparative analysis ; Cross-Sectional Studies ; Feces - microbiology ; Female ; Gastroenterology ; Health aspects ; Hepatology ; Humans ; Immunosuppressive agents ; Immunotherapy ; Inflammatory Bowel Diseases - epidemiology ; Inflammatory Bowel Diseases - microbiology ; Male ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Michigan - epidemiology ; Middle Aged ; Oncology ; Original Article ; Polymerase Chain Reaction ; Prevalence ; Prevalence studies (Epidemiology) ; Prospective Studies ; Transplant Surgery ; Ulcerative colitis</subject><ispartof>Digestive diseases and sciences, 2020-11, Vol.65 (11), p.3287-3296</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>COPYRIGHT 2020 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-a2a7c5a1e0d6d5a33e0af9cdfaee0f3e8e8734b35cd405620e2bbf4197b0862a3</citedby><cites>FETCH-LOGICAL-c414t-a2a7c5a1e0d6d5a33e0af9cdfaee0f3e8e8734b35cd405620e2bbf4197b0862a3</cites><orcidid>0000-0003-1602-4341</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31981111$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Limsrivilai, Julajak</creatorcontrib><creatorcontrib>Saleh, Zachary M.</creatorcontrib><creatorcontrib>Johnson, Laura A.</creatorcontrib><creatorcontrib>Stidham, Ryan W.</creatorcontrib><creatorcontrib>Waljee, Akbar K.</creatorcontrib><creatorcontrib>Govani, Shail M.</creatorcontrib><creatorcontrib>Gutermuth, Brian</creatorcontrib><creatorcontrib>Brown, Alexandra M.</creatorcontrib><creatorcontrib>Briggs, Emily</creatorcontrib><creatorcontrib>Rao, Krishna</creatorcontrib><creatorcontrib>Higgins, Peter D. R.</creatorcontrib><title>Prevalence and Effect of Intestinal Infections Detected by a PCR-Based Stool Test in Patients with Inflammatory Bowel Disease</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>Background
The advent of PCR-based stool testing has identified a greatly increased number of infectious agents in IBD, but their clinical significance is unknown.
Aims
To determine the infectious agent prevalence and the clinical significance of these infectious agents in IBD patients.
Methods
This cross-sectional study compared the prevalence of GI infections among IBD patients with active and quiescent disease versus healthy controls. Among actively inflamed patients, we compared clinical characteristics, medication use, and disease course between those with positive and negative tests.
Results
Three hundred and thirty-three IBD patients and 52 healthy volunteers were included. The IBD group was divided into active Crohn’s disease (CD,
n
= 113), inactive CD (
n
= 53), active ulcerative colitis (UC,
n
= 128), and inactive UC (
n
= 39). A significantly higher percentage of actively inflamed patients had positive stool tests (31.1%) compared to those with quiescent disease (7.6%,
P
= < 0.001) and healthy controls (13.5%,
P
= 0.01). In actively inflamed patients, shorter symptom duration and the use of multiple immunosuppressive agents were significantly associated with positive stool tests. Escalation of immunosuppressive therapy was less frequent in those with positive (61.3%) than with negative tests (77.7%,
P
= < 0.01). However, the need for surgery (13.3% vs. 18.7%, respectively,
P
= 0.31) and hospitalization (14.7% vs. 17.5%, respectively,
P
= 0.57) in 90 days was not significantly different.
Conclusion
GI infections are common in IBD patients with active disease. Evaluating patients for infection may help avoid unnecessary escalation of immunosuppressants, especially during an acute flare or combination immunosuppression.</description><subject>Adult</subject><subject>Bacterial Infections - epidemiology</subject><subject>Bacterial Infections - microbiology</subject><subject>Biochemistry</subject><subject>Care and treatment</subject><subject>Case-Control Studies</subject><subject>Comparative analysis</subject><subject>Cross-Sectional Studies</subject><subject>Feces - microbiology</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Health aspects</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Immunosuppressive agents</subject><subject>Immunotherapy</subject><subject>Inflammatory Bowel Diseases - epidemiology</subject><subject>Inflammatory Bowel Diseases - microbiology</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Michigan - epidemiology</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Polymerase Chain Reaction</subject><subject>Prevalence</subject><subject>Prevalence studies (Epidemiology)</subject><subject>Prospective Studies</subject><subject>Transplant Surgery</subject><subject>Ulcerative colitis</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kd9rFDEQx4Mo9jz9B3yQgC--bM2P3eztY3utbaHgofU5zGYnNWU3qUmu5R78382yVRDEhCGT5PMdhvkS8pazY85Y-zFxpgSr2ByKtbwSz8iKN62sRKM2z8mKcVVyztUReZXSHWOsa7l6SY4k7za8rBX5uYv4ACN6gxT8QM-tRZNpsPTKZ0zZeRhLOj-64BM9w1xSHGh_oEB32y_VKaRy_ZpDGOlNUVDn6Q6yQ58TfXT5-ywfYZogh3igp-ERR3rmEhbda_LCwpjwzdO5Jt8-nd9sL6vrzxdX25PrytS8zhUIaE0DHNmghgakRAa2M4MFRGYlbnDTyrqXjRlq1pSZoOh7W_Ou7dlGCZBr8mGpex_Dj31pUk8uGRxH8Bj2SQtZNw2rO94U9P2C3papaOdtyBHMjOuTlotOKqHqQh3_gyp7wMmZ4NG68v6XQCwCE0NKEa2-j26CeNCc6dlNvbip2Ryzm6WpNXn31Pa-n3D4I_ltXwHkAqTy5W8x6ruwj8Wy9L-yvwCldama</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Limsrivilai, Julajak</creator><creator>Saleh, Zachary M.</creator><creator>Johnson, Laura A.</creator><creator>Stidham, Ryan W.</creator><creator>Waljee, Akbar K.</creator><creator>Govani, Shail M.</creator><creator>Gutermuth, Brian</creator><creator>Brown, Alexandra M.</creator><creator>Briggs, Emily</creator><creator>Rao, Krishna</creator><creator>Higgins, Peter D. R.</creator><general>Springer US</general><general>Springer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1602-4341</orcidid></search><sort><creationdate>20201101</creationdate><title>Prevalence and Effect of Intestinal Infections Detected by a PCR-Based Stool Test in Patients with Inflammatory Bowel Disease</title><author>Limsrivilai, Julajak ; Saleh, Zachary M. ; Johnson, Laura A. ; Stidham, Ryan W. ; Waljee, Akbar K. ; Govani, Shail M. ; Gutermuth, Brian ; Brown, Alexandra M. ; Briggs, Emily ; Rao, Krishna ; Higgins, Peter D. R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-a2a7c5a1e0d6d5a33e0af9cdfaee0f3e8e8734b35cd405620e2bbf4197b0862a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Bacterial Infections - epidemiology</topic><topic>Bacterial Infections - microbiology</topic><topic>Biochemistry</topic><topic>Care and treatment</topic><topic>Case-Control Studies</topic><topic>Comparative analysis</topic><topic>Cross-Sectional Studies</topic><topic>Feces - microbiology</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Health aspects</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Immunosuppressive agents</topic><topic>Immunotherapy</topic><topic>Inflammatory Bowel Diseases - epidemiology</topic><topic>Inflammatory Bowel Diseases - microbiology</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Michigan - epidemiology</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Polymerase Chain Reaction</topic><topic>Prevalence</topic><topic>Prevalence studies (Epidemiology)</topic><topic>Prospective Studies</topic><topic>Transplant Surgery</topic><topic>Ulcerative colitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Limsrivilai, Julajak</creatorcontrib><creatorcontrib>Saleh, Zachary M.</creatorcontrib><creatorcontrib>Johnson, Laura A.</creatorcontrib><creatorcontrib>Stidham, Ryan W.</creatorcontrib><creatorcontrib>Waljee, Akbar K.</creatorcontrib><creatorcontrib>Govani, Shail M.</creatorcontrib><creatorcontrib>Gutermuth, Brian</creatorcontrib><creatorcontrib>Brown, Alexandra M.</creatorcontrib><creatorcontrib>Briggs, Emily</creatorcontrib><creatorcontrib>Rao, Krishna</creatorcontrib><creatorcontrib>Higgins, Peter D. R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Limsrivilai, Julajak</au><au>Saleh, Zachary M.</au><au>Johnson, Laura A.</au><au>Stidham, Ryan W.</au><au>Waljee, Akbar K.</au><au>Govani, Shail M.</au><au>Gutermuth, Brian</au><au>Brown, Alexandra M.</au><au>Briggs, Emily</au><au>Rao, Krishna</au><au>Higgins, Peter D. R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and Effect of Intestinal Infections Detected by a PCR-Based Stool Test in Patients with Inflammatory Bowel Disease</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>65</volume><issue>11</issue><spage>3287</spage><epage>3296</epage><pages>3287-3296</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><abstract>Background
The advent of PCR-based stool testing has identified a greatly increased number of infectious agents in IBD, but their clinical significance is unknown.
Aims
To determine the infectious agent prevalence and the clinical significance of these infectious agents in IBD patients.
Methods
This cross-sectional study compared the prevalence of GI infections among IBD patients with active and quiescent disease versus healthy controls. Among actively inflamed patients, we compared clinical characteristics, medication use, and disease course between those with positive and negative tests.
Results
Three hundred and thirty-three IBD patients and 52 healthy volunteers were included. The IBD group was divided into active Crohn’s disease (CD,
n
= 113), inactive CD (
n
= 53), active ulcerative colitis (UC,
n
= 128), and inactive UC (
n
= 39). A significantly higher percentage of actively inflamed patients had positive stool tests (31.1%) compared to those with quiescent disease (7.6%,
P
= < 0.001) and healthy controls (13.5%,
P
= 0.01). In actively inflamed patients, shorter symptom duration and the use of multiple immunosuppressive agents were significantly associated with positive stool tests. Escalation of immunosuppressive therapy was less frequent in those with positive (61.3%) than with negative tests (77.7%,
P
= < 0.01). However, the need for surgery (13.3% vs. 18.7%, respectively,
P
= 0.31) and hospitalization (14.7% vs. 17.5%, respectively,
P
= 0.57) in 90 days was not significantly different.
Conclusion
GI infections are common in IBD patients with active disease. Evaluating patients for infection may help avoid unnecessary escalation of immunosuppressants, especially during an acute flare or combination immunosuppression.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31981111</pmid><doi>10.1007/s10620-020-06071-2</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-1602-4341</orcidid></addata></record> |
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| ispartof | Digestive diseases and sciences, 2020-11, Vol.65 (11), p.3287-3296 |
| issn | 0163-2116 1573-2568 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2345504915 |
| source | Springer Link |
| subjects | Adult Bacterial Infections - epidemiology Bacterial Infections - microbiology Biochemistry Care and treatment Case-Control Studies Comparative analysis Cross-Sectional Studies Feces - microbiology Female Gastroenterology Health aspects Hepatology Humans Immunosuppressive agents Immunotherapy Inflammatory Bowel Diseases - epidemiology Inflammatory Bowel Diseases - microbiology Male Medical research Medicine Medicine & Public Health Medicine, Experimental Michigan - epidemiology Middle Aged Oncology Original Article Polymerase Chain Reaction Prevalence Prevalence studies (Epidemiology) Prospective Studies Transplant Surgery Ulcerative colitis |
| title | Prevalence and Effect of Intestinal Infections Detected by a PCR-Based Stool Test in Patients with Inflammatory Bowel Disease |
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