摘要
Background and aims:Superimposed Campylobacter jejuni infection(CJI)has been described in patients with ulcerative colitis(UC).Its risk factors and impact on the disease course of UC are not known.Our aims were to evaluate the risk factors for CJI in UC patients and the impact of the bacterial infection on outcomes of UC.Methods:Out of a total of 918 UC patients tested,21(2.3%)of patients were found to be positive for CJI(the study group).The control group comprised 84 age-matched UC patients who had tested negative for CJI.Risk factors for CJI and UC-related outcomes at 1 year after diagnosis of CJI were compared between the two groups.Results:Ten patients(47.6%)with CJI required hospital admission at the time of diagnosis,including eight for the management of“UC flare”.Treatment with antibiotics resulted in improvement in symptoms in 13 patients(61.9%).On multivariate analysis,hospital admission in the preceding year was found to be an independent risk factor for CJI[odds ratio(OR):3.9;95%confidence interval(CI):1.1–14.1]and there was a trend for chronic liver disease as a strong risk factor(OR:5.0;95%CI:0.9–28.3).At 1-year follow up,there was a trend for higher rates of UC-related colectomy(28.8% vs.14.3%;P=0.11),and mortality(9.5%vs.1.2%;P=0.096)in the study group.Conclusion:Recent hospitalization within 1 year was found to be associated with increased risk for CJI in UC patients.There was a trend for worse clinical outcomes of UC with in patients with superimposed CJI,which was frequently associated with UC flare requiring hospital admission.
背景与目的:空肠弯曲杆菌重复感染(CJI)在溃疡性结肠炎(UC)患者中已有描述,但其危险因素及对UC病程的影响尚不清楚。本研究旨在评估UC患者CJI的危险因素以及CJI对UC临床结局的影响。方法:918例UC患者接受了空肠弯曲杆菌的检测,其中21例(2.3%)发现CJI阳性(研究组)。对照组由84例年龄匹配的CJI阴性UC患者组成。分析CJI的危险因素,并对两组患者CJI诊断后1年的UC相关临床结局进行比较。结果:10例(47.6%)患者在CJI诊断时需要入院治疗,其中8例治疗是针对UC发作。经抗生素治疗后,13例(61.9%)CJI患者症状得以改善。多因素分析显示,细菌检测前1年内曾住院治疗是CJI的独立危险因素(OR=3.9,95%CI:1.1-14.1),而合并慢性肝病也可能是CJI的另一危险因素(OR=5.0,95%CI:0.92-8.3)。随访1年,研究组UC相关的结肠切除的比例(28.8%vs 14.3;P=0.11)和病死率(9.5%vs 1.2%;P=0.096)均有增高的趋势。结论:近1年内住院治疗可致UC患者CJI风险增高。合并CJI的UC患者临床结局似乎更差,常因UC发作接受入院治疗。
