Gut Liver.  2022 Sep;16(5):726-735. 10.5009/gnl210217.

Current Status of Opportunistic Infection in Inflammatory Bowel Disease Patients in Asia: A Questionnaire-Based Multicenter Study

• Yang H
• Ran Z
• Jin M
• Qian JM

• KMID: 2533181
• DOI: http://doi.org/10.5009/gnl210217

Abstract

Background/Aims
Opportunistic infection in inflammatory bowel disease (IBD) has become a serious problem. However, its status of doctors’ opinions and test equipment in hospitals are unclear. The aim of the study was to investigate these issues to improve the prognosis of IBD patients.
Methods
This retrospective, multicenter study was conducted by 83 investigators who were members of the Asian Organization for Crohn’s and Colitis. Data on opportunistic infection were collected from hospital databases between January 2017 and December 2017. The survey con sisted of 11 items.
Results
Most physicians appreciated the diagnostic value of tissue cytomegalovirus (CMV) DNA, accounting for 86.1% of members in China, 37.5% in Japan, 52.9% in South Korea, and 66.7% in Southeast Asia. Only 83.1% of hos­pitals had the ability to test for CMV immunohistochemistry in Asia. Hepatitis B surface antigen (HBsAg) screening was recommended by all members. However, only 66.7% in China, 70.6% in South Korea, and 66.7% in Southeast Asia agreed to routinely vaccinate IBD patients when HBsAg tested negative. Most members preferred metro nidazole (74.7%) as the first choice for patients with Clostridium difficile infection. However, the proportion of stool C. difficile toxin test was lower in China than in other areas (75.0% in China vs 95.8% in Japan and 100% in South Korea and Southeast Asia, p<0.05).
Conclusions
Opportunistic infection from CMV, hepatitis B virus, and C. difficile should be of high concern for IBD patients. More efforts are needed, such as understanding consensus in clinical practice and improving testing facilities in hospitals.

Keyword

Inflammatory bowel disease; Opportunistic infection; Asia; Questionnaire