P815 Are hospitalised patients with inflammatory bowel disease at increased risk of invasive bacterial infections? Results from POLIBD 2-year cohort study

Abstract

Abstract Background The disease itself as well as immunomodulatory and biological therapy are risk factors for invasive bacterial infections in patients with inflammatory bowel disease (IBD). However, there are limited data on risk factors for bacteraemia in the general population of hospitalised patients with inflammatory bowel disease. The aim of the study was to assess the rate of bacteraemia in hospitalised patients with Inflammatory Bowel Disease and risk factors. Methods An observational cohort of hospitalised patients with Inflammatory Bowel Disease, aged 23–65 years, from 2017 to 2019 in a large tertiary hospital localised in Rzeszow (south-eastern Poland). Patients with one or more positive blood culture were reviewed. Those with Carlson comorbidity index of 2 or greater were excluded. Basic descriptive statistic and logistic regression to evaluate risk factors for bacteraemia were used. Results Of 727 admitted patients, only 1.24% had bacteraemia (9/727) (8, Crohn’s Disease; 1, Ulcerative Colitis). The most common pathogens were Staphylococcus epidermidis (MRCNS - methicillin-resistant coagulase-negative Staphylococcus - strain resistant to all beta-lactam antibiotics: penicillins, penicillins with a B-lactamase inhibitor, cephalosporin and carbapenem) (4/9 patients) and Escherichia coli (3/9 patients). The mortality rate at 30 days of patients with bacteraemia was 0% (no deaths in IBD patients with bacteraemia observed). Longer hospitalisation (mean length of stay for patients with CD was 42 ± 33 vs. 7.95 ± 17.3, p <0.001; mean length of stay for a patient with UC 15 ± 23 vs. 6.25 ± 15.4, p = 0.004) was associated with an increased risk of bacteraemia. Older age was not associated with an increased risk of bacteraemia (P>0.05). In multivariate analysis, treatment with either anti-tumour necrosis factor α, purine analogues, steroids or amino salicylates was not associated with an increased risk of bacteraemia. Conclusion Prolonged hospitalisation, but not Inflammatory Bowel Disease-related treatment, is associated with an increased risk of bacteraemia in hospitalised patients with Inflammatory Bowel Disease.