Related Experiment Video
Updated: Dec 27, 2025
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
High risk of microscopic colitis after Campylobacter concisus infection: population-based cohort study
Hans Linde Nielsen1,2, Michael Dalager-Pedersen2,3, Henrik Nielsen2,3
1Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark halin@rn.dk.
Objective:
Microscopic colitis (MC) encompasses the two histopathological distinct entities of collagenous colitis (CC) and lymphocytic colitis (LC). In this Danish population-based cohort study, we examined the risk of MC following stool culture with Campylobacter concisus, C. jejuni, non-typhoidal Salmonella or a culture-negative stool test.
Design:
We identified patients with a first-time positive stool culture with C. concisus, C. jejuni, non-typhoidal Salmonella or negative stool test, from 2009 through 2013 in North Denmark Region, Denmark, and matched each with 10 population comparisons. All subjects were followed up until 1 March 2018 using Systematised Nomenclature of Medicine codes from The Danish Pathology Register for incident diagnoses of CC and LC. We computed risk and adjusted HRs with 95% CIs for MC among patients and comparisons.
Results:
We identified 962 patients with C. concisus, 1725 with C. jejuni, 446 with Salmonella and 11 825 patients with culture-negative stools. The MC risk and HR versus comparisons were high for patients with C. concisus (risk 6.2%, HR 32.4 (95% CI 18.9 to 55.6)), less for C. jejuni (risk 0.6%, HR 3.7 (95% CI 1.8 to 7.7)), low for Salmonella (risk 0.4%, HR 2.2 (95% CI 0.5 to 10.8)) and for patients with negative stool testing (risk 3.3%, HR 19.6 (95% CI 16.4 to 23.4)). After exclusion of the first year of follow-up, the HRs were 9.3 (95% CI 4.1 to 20.1), 2.2 (95% CI 0.9 to 5.4), 1.3 (95% CI 0.2 to 11.1) and 5.6 (95% CI 4.6 to 7.2), respectively.
Conclusion:
A high risk of MC was observed following C. concisus in stools. Further studies are needed to elucidate any underlying biological mechanisms.
Insights
A Danish study found a significantly increased risk of microscopic colitis (MC) after infection with Campylobacter concisus. This finding highlights a potential link between specific bacterial infections and MC development.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Epidemiology
Background:
- Microscopic colitis (MC) comprises collagenous colitis (CC) and lymphocytic colitis (LC).
- The association between specific gastrointestinal infections and MC risk remains incompletely understood.
Purpose of the Study:
- To investigate the risk of developing microscopic colitis (MC) following stool infections with specific bacteria.
- To examine the association between Campylobacter concisus, C. jejuni, Salmonella, and culture-negative stool tests and subsequent MC diagnoses.
Main Methods:
- A population-based cohort study in Denmark (2009-2013) identified patients with specific stool test results.
- Matched each patient with 10 population comparisons, followed up until 2018 using pathology register data.
- Calculated risk and adjusted hazard ratios (HRs) for MC incidence.
Main Results:
- A high risk of MC was observed in patients with Campylobacter concisus (HR 32.4).
- Elevated MC risk was also noted for C. jejuni (HR 3.7) and culture-negative stools (HR 19.6).
- Salmonella infection showed a low, non-significant increased risk (HR 2.2).
Conclusions:
- Campylobacter concisus infection is associated with a substantially increased risk of microscopic colitis.
- Further research is warranted to explore the biological mechanisms underlying this association.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...