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Edward L Barnes, Opportunistic Infections and Opportunities for Action, Inflammatory Bowel Diseases, Volume 26, Issue 2, February 2020, Pages 301–303, https://doi.org/10.1093/ibd/izz151
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The risk of infection among patients with inflammatory bowel disease (IBD) is a complex subject that continues to evolve with the emergence of new mechanisms of therapy and new approaches to treatment. It is well recognized that the patients with the most severe disease often require the most significant immunosuppression, and thus are at the greatest risk for opportunistic or secondary infections. Biologic therapies in particular have been associated with an increased risk for opportunistic infection1 and serious infections such as those requiring hospital admission or intravenous antibiotics.2 Although many risk factors for opportunistic infections in patients with IBD are directly related to immunosuppressive medications, several risk factors are inherent to individual patients, including age, comorbidities, and the presence of malnutrition.3
In this issue of Inflammatory Bowel Diseases, Sheriff et al. present an evaluation of the risk of opportunistic infections among patients with Crohn’s disease (CD) or ulcerative colitis (UC) compared with patients without IBD in a large commercial database representing all 50 states.4 The Explorys database includes de-identified data from >50 million patients and 26 integrated health systems, including 281,830 patients with IBD who were analyzed in this study. In these analyses, significantly higher rates of opportunistic infections were noted among patients with IBD as compared with patients without IBD.
