The Prevalence and Risk Factors of <i>Clostridioides difficile</i> Infection in Inflammatory Bowel Disease: 10-Year South Korean Experience Based on the National Database
- 주제(키워드) Clostridioides difficile , Pseudomembranous Enterocolitis , Inflammatory Bowel Diseases , Crohn Disease , Ulcerative Colitis
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Song, Eun Mi] Ewha Womans Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Choi, Arum; Kim, Sukil] Catholic Univ Korea, Coll Med, Dept Prevent Med & Publ Hlth, Seoul, South Korea; [Jung, Sung Hoon] Catholic Univ Korea, Eunpyeong St Marys Hosp, Coll Med, Dept Internal Med, 1021 Tongil Ro, Seoul 03312, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 Green Published; Gold Open Access
- 발행기관 KOREAN ACAD MEDICAL SCIENCES
- 발행년도 2023
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000213838
- 본문언어 영어
- Published As https://doi.org/10.3346/jkms.2023.38.e359
- PubMed 38050911
초록/요약
Background: Few studies evaluate the epidemiology and risk factors of Clostridioides difficile infection (CDI) in Asian patients with inflammatory bowel disease (IBD). We investigated the year-end prevalence, cumulative incidence and risk factors of CDI in Asian patients with IBD using a large-scale population-based cohort in Korea. Methods: Using the National Health Insurance Service database, we identified patients with IBD and sex-and age-matched controls without IBD between 2008 and 2018. The year-end prevalence and cumulative incidence of CDI were compared among patients with Crohn's disease (CD) and ulcerative colitis (UC) with controls. The risk factors for CDI were evaluated.Results: Among the 54,836 patients with IBD and 109,178 controls, CDI occurred in 293 patients with IBD and 87 controls. The annual year-end prevalence of CDI in patients with IBD increased from 8.6/10,000 persons in 2008 to 22.3/10,000 persons in 2018. The risk of CDI was higher in both patients with CD and UC than that in the matched controls (hazard ratio [HR], 7.285; 95% confidence interval [CI], 5.388-9.851; P < 0.001 and HR, 7.487; 95% CI, 5.796-9.670; P < 0.001, respectively). Among patients with IBD, the risk factors for CDI included older age, female sex, high Charlson comorbidity index score, and IBD-related medications including oral 5-aminosalicylic acid, immunomodulatory agents, biologics, and steroids used for > 90 days. Conclusion: The risk of CDI in Korean patients with IBD was approximately seven times higher than that in controls without IBD, and the annual year-end prevalence of CDI continuously increased from 2008 to 2018.
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