Colonic neoplasm detection in patients with Streptococcus gallolyticus septicaemia versus average-risk individuals: a retrospective matched cohort study from a tertiary care center in Thailand
3
Issued Date
2025-10-14
Resource Type
eISSN
20446055
Scopus ID
2-s2.0-105018651505
Pubmed ID
41087105
Journal Title
BMJ Open
Volume
15
Issue
10
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMJ Open Vol.15 No.10 (2025) , e103612
Suggested Citation
Nawalerspunya P., Pattarapuntakul T., Wong T., Sripongpun P., Saejaow S., Jongraksak T. Colonic neoplasm detection in patients with Streptococcus gallolyticus septicaemia versus average-risk individuals: a retrospective matched cohort study from a tertiary care center in Thailand. BMJ Open Vol.15 No.10 (2025) , e103612. doi:10.1136/bmjopen-2025-103612 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/112697
Title
Colonic neoplasm detection in patients with Streptococcus gallolyticus septicaemia versus average-risk individuals: a retrospective matched cohort study from a tertiary care center in Thailand
Corresponding Author(s)
Other Contributor(s)
Abstract
OBJECTIVE: To compare colorectal neoplasm detection rates between patients with Streptococcus gallolyticus septicaemia and average-risk individuals undergoing screening colonoscopy and identify predictors of neoplasm detection within the septicaemia group. DESIGN: A retrospective matched cohort study SETTING: Tertiary care university hospital in Southern Thailand. PARTICIPANTS: Eighty-five patients with S. gallolyticus septicaemia and 279 average-risk individuals who underwent colonoscopy between 2014 and 2024. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcomes included the polyp detection rate (PDR), adenoma detection rate (ADR), advanced adenoma detection rate (aADR) and adenocarcinoma detection rate. Logistic regression was used to estimate ORs with 95% CIs. RESULTS: In an unmatched analysis, the ADR (41.2% vs 26.9%, OR 1.90, 95% CI 1.15 to 3.16, p=0.014) and adenocarcinoma detection rate (12.9% vs 2.9%, OR 5.04, 95% CI 1.95 to 12.97, p<0.001) were significantly higher in the septicaemia group, whereas the PDR and aADR were not significantly different. In the age- and sex-matched analysis (n=50 pairs), detection rates were comparable, except for a lower PDR in the septicaemia group (44% vs 70%, OR 0.34, 95% CI 0.14 to 0.76, p=0.008). Subgroup analysis within the septicaemia group identified older age (adjusted OR 1.04 per year, 95% CI 1.01 to 1.08, p=0.023) and diabetes mellitus (adjusted OR 2.79, 95% CI 1.15 to 6.81, p=0.034) as independent predictors of colonic neoplasm detection. Importantly, colonoscopy performed after the septicaemia episode was independently associated with a markedly higher likelihood of neoplasm detection than procedures done before septicaemia (adjusted OR 4.88, 95% CI 1.70 to 14.05, p=0.002), indicating that repeat colonoscopy may be warranted even in patients who had undergone the procedure within the previous 6 months. CONCLUSIONS: S. gallolyticus septicaemia was linked to higher adenoma and adenocarcinoma detection rates, with age and diabetes mellitus further increasing such risk. Even patients who underwent colonoscopy within 6 months before septicaemia benefited from repeat colonoscopy, supporting its consideration to prevent missed or rapidly developing lesions.