Abstract：
BACKGROUND: Limited reports exist regarding invasive fungal diseases (IFDs) in inflammatory bowel disease (IBD) patients.
OBJECTIVE: This study aims to investigate the incidence and risk factors of IFDs, specifically invasive candidiasis, aspergillosis and pneumocystosis, in IBD patients in South Korea using nationwide data.
METHODS: A population-based retrospective cohort of 42,913 IBD patients between January 2010 and December 2018 was evaluated using the Health Insurance Review and Assessment database. The primary outcome was the incidence of IFDs, including invasive candidiasis, aspergillosis and pneumocystosis, while the secondary outcome involved analysing the risk factors associated with each specific infection.
RESULTS: The study included a total of 42,913 IBD patients, with 29,909 (69.7%) diagnosed with ulcerative colitis (UC) and 13,004 (30.3%) diagnosed with Crohn\'s disease (CD). IFDs occurred in 166 IBD patients (0.4%), with 93 cases in UC patients and 73 cases in CD patients. The incidence rates of invasive candidiasis, aspergillosis and pneumocystosis in IBD patients were 0.71 per 1000 person-years (PYs), 0.15 per 1000 PYs and 0.12 per 1000 PYs, respectively. The cumulative incidence of invasive candidiasis (adjusted p-value <.001) and Pneumocystosis (adjusted p-value = .012) was found to be higher in CD patients than in UC patients. Each IFD had different risk factors, including IBD subtypes, age at diagnosis, anti-tumour necrotic factor agents or the Charlson comorbidity index.
CONCLUSIONS: Based on nationwide data in South Korea, this study shows that IFDs occur consistently in patients with IBD, albeit with a low frequency.
OBJECTIVE: This study aims to investigate the incidence and risk factors of IFDs, specifically invasive candidiasis, aspergillosis and pneumocystosis, in IBD patients in South Korea using nationwide data.
METHODS: A population-based retrospective cohort of 42,913 IBD patients between January 2010 and December 2018 was evaluated using the Health Insurance Review and Assessment database. The primary outcome was the incidence of IFDs, including invasive candidiasis, aspergillosis and pneumocystosis, while the secondary outcome involved analysing the risk factors associated with each specific infection.
RESULTS: The study included a total of 42,913 IBD patients, with 29,909 (69.7%) diagnosed with ulcerative colitis (UC) and 13,004 (30.3%) diagnosed with Crohn\'s disease (CD). IFDs occurred in 166 IBD patients (0.4%), with 93 cases in UC patients and 73 cases in CD patients. The incidence rates of invasive candidiasis, aspergillosis and pneumocystosis in IBD patients were 0.71 per 1000 person-years (PYs), 0.15 per 1000 PYs and 0.12 per 1000 PYs, respectively. The cumulative incidence of invasive candidiasis (adjusted p-value <.001) and Pneumocystosis (adjusted p-value = .012) was found to be higher in CD patients than in UC patients. Each IFD had different risk factors, including IBD subtypes, age at diagnosis, anti-tumour necrotic factor agents or the Charlson comorbidity index.
CONCLUSIONS: Based on nationwide data in South Korea, this study shows that IFDs occur consistently in patients with IBD, albeit with a low frequency.
摘要：
背景：关于炎症性肠病（IBD）患者的侵袭性真菌病（IFD）的报道有限。
目的：本研究旨在调查IFD的发生率和危险因素，特别是侵袭性念珠菌病，曲霉病和肺孢子菌病，在韩国IBD患者中使用全国数据。
方法：使用健康保险审查和评估数据库评估了2010年1月至2018年12月期间42,913例IBD患者的基于人群的回顾性队列。主要结果是IFD的发生率，包括侵袭性念珠菌病,曲霉病和肺孢子菌病，而次要结局涉及分析与每种特定感染相关的危险因素。
结果：该研究共纳入42,913例IBD患者，29,909（69.7％）诊断为溃疡性结肠炎（UC）和13,004（30.3％）诊断为克罗恩病（CD）。166例IBD患者发生IFD（0.4%），其中UC患者93例,CD患者73例。侵袭性念珠菌病的发病率，IBD患者的曲霉病和肺孢子病为0.71/1000人年（PYs），每1000个PY为0.15个，每1000个PY为0.12个，分别。发现CD患者的侵袭性念珠菌病（调整后p值<.001）和肺孢子菌病（调整后p值=.012）的累积发病率高于UC患者。每个IFD都有不同的风险因素，包括IBD亚型，诊断时的年龄，抗肿瘤坏死因子剂或Charlson合并症指数。
结论：根据韩国的全国数据，这项研究表明，IFD在IBD患者中持续发生，尽管频率很低。
目的：本研究旨在调查IFD的发生率和危险因素，特别是侵袭性念珠菌病，曲霉病和肺孢子菌病，在韩国IBD患者中使用全国数据。
方法：使用健康保险审查和评估数据库评估了2010年1月至2018年12月期间42,913例IBD患者的基于人群的回顾性队列。主要结果是IFD的发生率，包括侵袭性念珠菌病,曲霉病和肺孢子菌病，而次要结局涉及分析与每种特定感染相关的危险因素。
结果：该研究共纳入42,913例IBD患者，29,909（69.7％）诊断为溃疡性结肠炎（UC）和13,004（30.3％）诊断为克罗恩病（CD）。166例IBD患者发生IFD（0.4%），其中UC患者93例,CD患者73例。侵袭性念珠菌病的发病率，IBD患者的曲霉病和肺孢子病为0.71/1000人年（PYs），每1000个PY为0.15个，每1000个PY为0.12个，分别。发现CD患者的侵袭性念珠菌病（调整后p值<.001）和肺孢子菌病（调整后p值=.012）的累积发病率高于UC患者。每个IFD都有不同的风险因素，包括IBD亚型，诊断时的年龄，抗肿瘤坏死因子剂或Charlson合并症指数。
结论：根据韩国的全国数据，这项研究表明，IFD在IBD患者中持续发生，尽管频率很低。
