炎症性肠病合并细菌感染

Bacterial Infection in Inflammatory Bowel Disease

炎症性肠病(IBD)病因不明,微生物异常包括肠道微生态紊乱及某些病原微生物感染可能是其发病和反复发作的重要触发因素。研究发现缓解期IBD的复发常常由一些肠道感染因素诱发,因此在活动期的患者中经常可以发现肠道病原微生物的重叠感染,另一方面由于IBD在治疗过程中经常会使用免疫抑制剂、生物制剂及皮质激素等药物,本身机会感染的可能性也大大增加,例如难辨梭状芽孢杆菌、巨细胞病毒等,造成了病情的加重以及治疗困难。本文就IBD与细菌感染的关系综述如下。

Although the ultimate cause of IBD is still unknown, microbiological factors have been proposed as possible triggers. Both alterations in the patient＇s intestinal microbiota and infections by external agents might play important roles in the IBD onset and the IBD flares. The treatment of IBD has been revolutionized over the past decade by the improved using of immunomodulators and biologic agents, that increased intestinal superinfections and opportunistic infection in IBD patients, increase co-morbidity and aggravate the diagnostic and therapeutic burden. Thus, an early recognition of complicating infections with targeted therapeutic approach is needed and probably could ensure a better prognosis for IBD patients. This paper reviews the intestinal bacterial superinfection, opportunistic bacterial infection, the risk factors and the management of this clinical setting.