TY - JOUR
T1 - Gut colonization with extended-spectrum β-lactamase-producing Enterobacteriaceae may increase disease activity in biologic-naive outpatients with ulcerative colitis
T2 - An interim analysis
AU - Skuja, Vita
AU - Derovs, Aleksejs
AU - Pekarska, Katrina
AU - Rudzite, Dace
AU - Lavrinovica, Elvira
AU - Piekuse, Linda
AU - Kempa, Inga
AU - Straume, Zane
AU - Eglite, Jelena
AU - Lejnieks, Aivars
AU - Krūmiņa, Angelika
AU - Eliakim, Rami
N1 - Funding Information:
The study was carried out according to the Helsinki Declaration, and reviewed and approved by the local Ethics committee (Riga East Clinical University Hospital Support Fund, Medical and Biomedical Research Ethics Committee).
Publisher Copyright:
© 2017 Wolters Kluwer Health, Inc. All rights reserved.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/1
Y1 - 2018/1
N2 - Background Certain Enterobacteriaceae strains have been associated with the development of ulcerative colitis (UC). Extended-spectrum lactamase (ESBL)-producing Enterobacteriaceae are the most commonly found multi-drug-resistant (MDR) bacteria colonizing the gut in UC patients and might trigger a more severe disease activity in UC patients. Objective The aim of this study was to evaluate whether disease activity is higher in UC patients with gut colonization with ESBL-producing Enterobacteriaceae. Materials and methods A cross-sectional, pilot study was carried out in a tertiary medical center in Latvia. Demographic data were collected; UC disease activity and extent were evaluated according to the full Mayo score, Montreal classification, and adapted Truelove and Witt's index. Rectal swabs with fecal biomaterial were collected, ESBL-producing Enterobacteriaceae were isolated, and bacterial plasmid genes responsible for ESBL production, blaCTX-M, blaTEM, and blaSHV, were detected. UC disease activity was compared in patients with and without gut colonization with ESBL-producing Enterobacteriaceae. Results A total of 65 patients with UC were included in the initial analysis. Gut colonization with ESBL-producing Enterobacteriaceae was found in seven (11%) patients - mostly Escherichia coli [5 (71%)] containing the blaCTX-M bacterial plasmid gene. Patients with gut colonization with ESBL-producing Enterobacteriaceae had more severe disease compared with patients without gut colonization according to the full Mayo score (5.86 vs. 3.40; P= 0.015), Montreal classification (moderate disease vs. clinical remission; P=0.031), and adapted Truelove and Witt's index (moderate disease vs. mild disease; P= 0.008). Conclusion Gut colonization with ESBL-producing Enterobacteriaceae may increase UC disease activity. Further research is needed to analyze the possible confounding factors that could contribute toward this outcome. Eur J Gastroenterol Hepatol 30:92-100.
AB - Background Certain Enterobacteriaceae strains have been associated with the development of ulcerative colitis (UC). Extended-spectrum lactamase (ESBL)-producing Enterobacteriaceae are the most commonly found multi-drug-resistant (MDR) bacteria colonizing the gut in UC patients and might trigger a more severe disease activity in UC patients. Objective The aim of this study was to evaluate whether disease activity is higher in UC patients with gut colonization with ESBL-producing Enterobacteriaceae. Materials and methods A cross-sectional, pilot study was carried out in a tertiary medical center in Latvia. Demographic data were collected; UC disease activity and extent were evaluated according to the full Mayo score, Montreal classification, and adapted Truelove and Witt's index. Rectal swabs with fecal biomaterial were collected, ESBL-producing Enterobacteriaceae were isolated, and bacterial plasmid genes responsible for ESBL production, blaCTX-M, blaTEM, and blaSHV, were detected. UC disease activity was compared in patients with and without gut colonization with ESBL-producing Enterobacteriaceae. Results A total of 65 patients with UC were included in the initial analysis. Gut colonization with ESBL-producing Enterobacteriaceae was found in seven (11%) patients - mostly Escherichia coli [5 (71%)] containing the blaCTX-M bacterial plasmid gene. Patients with gut colonization with ESBL-producing Enterobacteriaceae had more severe disease compared with patients without gut colonization according to the full Mayo score (5.86 vs. 3.40; P= 0.015), Montreal classification (moderate disease vs. clinical remission; P=0.031), and adapted Truelove and Witt's index (moderate disease vs. mild disease; P= 0.008). Conclusion Gut colonization with ESBL-producing Enterobacteriaceae may increase UC disease activity. Further research is needed to analyze the possible confounding factors that could contribute toward this outcome. Eur J Gastroenterol Hepatol 30:92-100.
KW - BlaCTX-M
KW - Disease activity
KW - Enterobacteriaceae
KW - Escherichia coli
KW - Extended-spectrum βl-lactamase
KW - Inflammatory bowel disease
KW - Ulcerative colitis
UR - http://www.scopus.com/inward/record.url?scp=85047775127&partnerID=8YFLogxK
U2 - 10.1097/MEG.0000000000000989
DO - 10.1097/MEG.0000000000000989
M3 - Article
C2 - 29076938
AN - SCOPUS:85047775127
SN - 0954-691X
VL - 30
SP - 92
EP - 100
JO - European Journal of Gastroenterology and Hepatology
JF - European Journal of Gastroenterology and Hepatology
IS - 1
ER -