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Current insight into enteropathogens in flare-up ulcerative colitis. An observational study.
Elham Ahmed Hassan1, Abeer Sharaf El-Din Abdel Rehim1, Asmaa Omar Ahmed2
1Department of Gastroenterology and Tropical Medicine.
European Journal of Gastroenterology & Hepatology
|May 10, 2023
Summary
Enteric infections, including multidrug-resistant organisms, are common in ulcerative colitis flares, particularly active disease. Identifying these pathogens is crucial for managing ulcerative colitis exacerbations and improving patient outcomes.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Ulcerative colitis (UC) incidence is rising globally.
- Enteric infections pose a significant challenge in managing UC flares.
Purpose of the Study:
- To identify enteropathogens in UC patients experiencing flares.
- To determine antimicrobial susceptibilities of identified pathogens.
- To investigate the relationship between enteropathogens and UC disease activity.
Main Methods:
- Stool samples analyzed from 95 UC patients (17 inactive, 78 active) using Mayo score.
- Enteropathogen detection via automated VITEK2 system and FilmArray gastrointestinal pathogen panel.
Main Results:
- Enteric infections detected in 85.3% of patients, significantly higher in active UC (96.2%).
- Common pathogens included E. coli, Cryptosporidium, and Norovirus.
- Mixed infections (70.7%), multidrug-resistant organisms (MDROs) (52.9%), and opportunistic infections (46.7%) were prevalent. Raoultella ornithinolytica identified as a novel UC flare pathogen.
- Multiple organisms, MDROs, and specific resistant bacteria linked to increased disease severity.
Conclusions:
- Identifying opportunistic and MDR enteropathogens in UC flares is critical due to diagnostic and therapeutic challenges.
- Regular monitoring of microbial profiles and antimicrobial resistance is essential for antibiotic stewardship and improved UC management.
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