The Prevalence of Adherent-Invasive Escherichia coli and Its Association With Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis.

Razie Kamali Dolatabadi,Peyman Adibi,Mehrdad Halaji,Hossein Fazeli,Awat Feizi

doi:10.3389/fmed.2021.730243

Abstract

Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are known as chronic gastrointestinal inflammatory disorders. The present systematic review and meta analysis was conducted to estimate the prevalence of adherent-invasive Escherichia coli (AIEC) isolates and their phylogenetic grouping among IBD patients compared with the controls. A systematic literature search was conducted among published papers by international authors until April 30, 2020 in Web of Science, Scopus, EMBASE, and PubMed databases. The pooled prevalence of AIEC isolates and their phylogenetic grouping among IBD patients as well as in controls was estimated using fixed or random effects models. Furthermore, for estimating the association of colonization by AIEC with IBD, odds ratio along with 95% confidence interval was reported. A total of 205 articles retrieved by the initial search of databases, 13 case–control studies met the eligibility criteria for inclusion in the meta analysis. There were 465 IBD cases (348 CD and 117 UC) and 307 controls. The pooled prevalence of AIEC isolates were 28% (95% CI: 18–39%), 29% (95% CI: 20–40%), 13% (95% CI: 1–30%), and 9% (95% CI: 3–19%), respectively among IBD, CD, UC, and control group, respectively. Our results revealed that the most frequent AIEC phylogroup in the IBD, CD, and control groups was B2. Fixed-effects meta analysis showed that colonization of AIEC is significantly associated with IBD (OR: 2.93; 95% CI: 1.90–4.52; P < 0.001) and CD (OR: 3.07; 95% CI: 1.99–4.74; P < 0.001), but not with UC (OR: 2.29; 95% CI: 0.81–6.51; P = 0.11). In summary, this meta analysis revealed that colonization by AIEC is more frequent in IBD and is associated with IBD (CD and UC). Our results suggested that the affects of IBD in patients colonized with the AIEC pathovar is not random, it is in fact a specific disease-related pathovar.

Highlights

Inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative coliti (UC), are chronic incurable gastrointestinal inflammatory disorders with unknown etiology [1]
Our results suggested that the affects of IBD in patients colonized with the adherent-invasive Escherichia coli (AIEC) pathovar is not random, it is a specific disease-related pathovar
We evaluated the association of AIEC with IBD, and the prevalence of AIEC was compared between patients and control groups, and for quantifying the association of colonization by AIEC with IBD, the odds ratio (OR) and 95% confidence interval for OR

Summary

Introduction

Inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative coliti (UC), are chronic incurable gastrointestinal inflammatory disorders with unknown etiology [1]. IBDs were regarded as a disease prevalent in industrialized countries. In the 21st century, as the epidemiological trend of this disease changed, IBDs have become a global problem, and new cases in developing countries in Asia, South America, and Africa are on the rise [2]. They are probably the result of improper and continuous initiation of the intestinal mucosal immune system due to the complicated interactions of genetics, microbial, and immunological agents [3]. According to the recent molecular studies on patients with IBD, beneficial bacteria, for instance, Firmicutes and Bacteroidetes, have reduced, and pathogenic bacteria, for example, Proteobacteriae, Escherichia coli, have increased [5]

Methods

Results

Discussion

Conclusion