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Title: Prevalence and Effect of Intestinal Infections Detected by a PCR-Based Stool Test in Patients with Inflammatory Bowel Disease
Authors: Julajak Limsrivilai
Zachary M. Saleh
Laura A. Johnson
Ryan W. Stidham
Akbar K. Waljee
Shail M. Govani
Brian Gutermuth
Alexandra M. Brown
Emily Briggs
Krishna Rao
Peter D.R. Higgins
VA Ann Arbor Healthcare System
University of Michigan Medical School
University of Michigan, Ann Arbor
Faculty of Medicine, Siriraj Hospital, Mahidol University
Keywords: Biochemistry, Genetics and Molecular Biology;Medicine
Issue Date: 1-Jan-2020
Citation: Digestive Diseases and Sciences. (2020)
Abstract: © 2020, Springer Science+Business Media, LLC, part of Springer Nature. 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.
ISSN: 15732568
Appears in Collections:Scopus 2020

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