Increased Risk of Inflammatory Bowel Disease Among Patients With Nontyphoidal Salmonella Infections: A Population-Based Cohort Study

被引:1
作者
Lin, Zong-Han [1 ]
Li, Chung-Pin [2 ,3 ,4 ,5 ]
Sun, Cheuk-Kwan [6 ,7 ]
Cho, Der-Yang [8 ,9 ,10 ]
Tsai, Fuu-Jen [11 ,12 ,13 ,14 ]
Yip, Hei-Tung [15 ]
Chang, Renin [16 ,17 ]
Hung, Yao-Min [18 ,19 ,20 ,21 ]
机构
[1] Kaohsiung Vet Gen Hosp, Dept Med Educ & Res, Kaohsiung, Taiwan
[2] Taipei Vet Gen Hosp, Dept Med, Div Gastroenterol & Hepatol, Taipei, Taiwan
[3] Taipei Vet Gen Hosp, Dept Med Educ, Div Clin Skills Training, Taipei, Taiwan
[4] Natl Yang Ming Chiao Tung Univ, Coll Med, Sch Med, Taipei, Taiwan
[5] Taipei Vet Gen Hosp, Therapeut & Res Ctr Pancreat Canc, Taipei, Taiwan
[6] I Shou Univ, E Da Dachang Hosp, Dept Emergency Med, Kaohsiung, Taiwan
[7] I Shou Univ, Coll Med, Sch Med Int Students, Kaohsiung, Taiwan
[8] China Med Univ Hosp, Translat Cell Therapy Ctr, Dept Med Res, Taichung, Taiwan
[9] China Med Univ Hosp, Dept Neurosurg, Taichung, Taiwan
[10] China Med Univ, Grad Inst Biomed Sci, Taichung, Taiwan
[11] China Med Univ, Coll Chinese Med, Sch Chinese Med, Taichung, Taiwan
[12] China Med Univ Hosp, Dept Med Res, Taichung, Taiwan
[13] China Med Univ, Div Med Genet, Childrens Hosp, Taichung, Taiwan
[14] Asia Univ, Dept Biotechnol & Bioinformat, Taichung, Taiwan
[15] China Med Univ Hosp, Management Off Hlth Data, Taichung, Taiwan
[16] Kaohsiung Vet Gen Hosp, Div Med Res, Kaohsiung, Taiwan
[17] Kaohsiung Vet Gen Hosp, Dept Emergency Med, Kaohsiung, Taiwan
[18] Taipei Vet Gen Hosp, Dept Internal Med, Div Nephrol, Taitung Branch, Taitung, Taiwan
[19] Natl Taitung Univ, Coll Sci & Engn, Master Program Biomed, Taitung, Taiwan
[20] Meiho Univ, Coll Hlth & Nursing, Pingtung, Taiwan
[21] Taipei Vet Gen Hosp, Div Nephrol, Taitung Branch, 1000 Gengsheng Rd, Taitung 95050, Taiwan
关键词
nontyphoidal Salmonella; NTS; inflammatory bowel disease; IBD; Crohn's disease; ulcerative colitis; cohort study; COLONIC MUCUS BARRIER; GUT MICROBIOTA; ANTIBIOTIC USE; GASTROINTESTINAL INFECTION; CROHNS; HOST; PREVALENCE; COLITIS; SMOKING; PROVIDE;
D O I
10.1093/ibd/izae053
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Despite the known association between microorganisms and development of inflammatory bowel disease (IBD), the role of nontyphoidal Salmonella (NTS) in IBD is not adequately addressed. We aimed at elucidating the relationship between NTS infection and the risk of IBD.Methods Based on the National Health Insurance Research Database in Taiwan, this retrospective cohort study enrolled patients with NTS infection (exposure group; n = 4651) and those without NTS infection (comparator group; n = 4651) who were propensity score matched (1:1) by demographic data, medications, comorbidities, and index date. All patients were followed until IBD onset, individual mortality, or December 31, 2018. Cox proportional hazards regression analysis was performed to determine the hazard ratios and 95% confidence intervals (CIs). Sensitivity analyses were used for cross-validation.Results The NTS group demonstrated an increased risk of IBD compared with the non-NTS groups (adjusted hazard ratio [aHR], 2.12; 95% CI, 1.62-2.78) with a higher risk of developing ulcerative colitis in the former (aHR, 2.27; 95% CI, 1.69-3.04). Nevertheless, the small sample size may contribute to lack of significant difference in Crohn's disease. Consistent findings were noted after excluding IBD diagnosed within 6 months of NTS infection (aHR, 2.28; 95% CI, 1.71-3.03), excluding those with enteritis/colitis before index date (aHR, 1.85; 95% CI, 1.28-2.68), excluding those using antibiotics for 1 month in the year before IBD onset (aHR, 1.81; 95% CI, 1.34-2.45), inverse probability of treatment weighting (aHR, 1.64; 95% CI, 1.31-2.04), and inclusion of individuals regardless of age (n = 10 431; aHR, 1.83; 95% CI, 1.53-2.19).Conclusions Patients with NTS were associated with an increased risk of developing IBD, especially ulcerative colitis.
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页码:351 / 361
页数:11
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