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J Coll Physicians Surg Pak · Oct 2020
Observational StudyOpportunistic Infection in Hospitalised Patients with Inflammatory Bowel Disease.
- Jin-Qiu Zhou, Zhang-Min Meng, Tao Zhang, Xing-Tao Jing, and Hua-Tian Gan.
- Department of Geriatrics Medicine and the Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
- J Coll Physicians Surg Pak. 2020 Oct 1; 30 (10): 1015-1020.
ObjectiveTo investigate the incidence, clinical features, and risk factors of opportunistic infections in elderly patients with inflammatory bowel disease (IBD).Study DesignObservational study.Place And Duration Of StudyDepartment of Digestive and Geriatrics Center, Sichuan University West China Hospital, China between January 2012 and January 2019.MethodologyPatients (≥18 years) with IBD were enrolled in this study. Clinical data from the infected elderly group (age ≥60 years), non-infected elderly group (age ≥60 years) and infected adult group (age: 18-59 years) were compared. Logistic regression analysis was used for risk factors associated with opportunistic infection.Results A total of 8.9% (307/3,456) of patients with IBD had opportunistic infection. The opportunistic infection rate of elderly group was 16.5% (80/485), which was significantly higher than that of adult group (7.6%, 227/2,971, p <0.05). Compared with infected adult group or non-infected elderly group, infected elderly group had less fever and leukocytosis, but more hypoproteinemia and several activities (p <0.05). Cytomegalovirus and Epstein-Barr virus were the most common agents in elderly group and adult group, respectively. Multiple episodes (three or more) were more common in infected elderly group; the time of opportunistic infections was associated with systemic inflammatory reaction syndrome (SIRS, p <0.05). Logistic regression analysis showed that age ≥60 years, corticosteroids, immunosuppressive and biological agents were risk factors for opportunistic infections in patients with IBD.ConclusionHospitalised elderly IBD patients, receiving corticosteroids, immunosuppressive, and biological agents, are at higher risk for infection. The symptoms of opportunistic infections in elderly patients are atypical, but they are prone to multiple infections with poor prognosis. Key Words: Elderly patients, Inflammatory bowel disease, Opportunistic infection, Systemic inflammation reaction syndrome.
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