title: Infection-related hospitalizations in the first year after inflammatory bowel disease diagnosis.
abstract: OBJECTIVE
  With the rapid increase in the incidence of inflammatory bowel disease (IBD) in Asia, the natural course of the early phase of disease in these patients remains poorly defined. This study aimed to determined the incidence and characteristics of infection-related hospitalization in the first year in patients newly diagnosed with IBD in Hong Kong SAR, China.
  
  
  METHODS
  Patients newly diagnosed with IBD and enrolled in the territory-wide Hong Kong IBD Registry were identified. Details of their hospitalization within the first 12 months after diagnosis were retrieved and analyzed.
  
  
  RESULTS
  Altogether 433 newly diagnosed IBD patients were enrolled, including 188 with Crohn's disease (CD), 230 with ulcerative colitis (UC) and 15 with IBD-unclassified (IBD-U). Among them, 110 (25.4%) had at least one unscheduled hospitalization in the first year and 34 (7.9%) had infection-related hospitalization, leading to 43 (23.4%) of total hospitalizations. Gastrointestinal tract (30.2%), respiratory tract (34.9%) and skin and soft tissues (11.6%) were the most common sites of infection. Bacterial and viral infections accounted for 46.7% and 20.8% of hospitalizations for infection, respectively. Common identified pathogens included Clostridium difficile (16.3%) and Cytomegalovirus (11.6%). Multivariate analysis found that patient's age (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.01-1.06) and the presence of comorbidity (OR 2.32, 95% CI 1.05-5.13) were significantly associated with hospitalization from infection in IBD patients.
  
  
  CONCLUSIONS
  Infection-related hospitalizations were found in 7.9% of newly diagnosed IBD patients within the first year after diagnosis in Hong Kong, which accounted for about one-quarter of all unscheduled hospitalizations. Elder patients with concurrent illnesses were at higher risk.
authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Michael Kwan-Lung
authors.initials: MK
authors.lastname: Ko
authors.affiliation: Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Siew C
authors.initials: SC
authors.lastname: Ng
authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Lung-Yi
authors.initials: LY
authors.lastname: Mak
authors.affiliation: Department of Medicine and Geriatrics, Tuen Mun Hospital, Kowloon, Hong Kong SAR, China.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Li
authors.affiliation: Department of Medicine and Geriatrics, United Christian Hospital, Kowloon, Hong Kong SAR, China.
authors.forename: Fu Hang
authors.initials: FH
authors.lastname: Lo
authors.affiliation: Department of Medicine and Geriatrics, Princess Margaret Hospital, Kowloon, Hong Kong SAR, China.
authors.forename: Carmen Ka Man
authors.initials: CK
authors.lastname: Ng
authors.affiliation: Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
authors.forename: Wai Cheung
authors.initials: WC
authors.lastname: Lao
authors.affiliation: Department of Medicine, Tseung Kwan O Hospital, Hong Kong SAR, China.
authors.forename: Steve
authors.initials: S
authors.lastname: Tsang
authors.affiliation: Department of Medicine, North District Hospital, New Territorities, Hong Kong SAR, China.
authors.forename: Kam Hon
authors.initials: KH
authors.lastname: Chan
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, Kowloon, Hong Kong SAR, China.
authors.forename: Yee Tak
authors.initials: YT
authors.lastname: Hui
authors.affiliation: Department of Medicine and Geriatrics, Caritas Medical Centre, Kowloon, Hong Kong SAR, China.
authors.forename: Edwin Hok Shing
authors.initials: EH
authors.lastname: Shan
authors.affiliation: Department of Medicine and Geriatrics, Kwong Wah Hospital, Kowloon, Hong Kong SAR, China.
authors.forename: Ching Kong
authors.initials: CK
authors.lastname: Loo
authors.affiliation: Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, New Territorities, Hong Kong SAR, China.
authors.forename: Aric J
authors.initials: AJ
authors.lastname: Hui
authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Wai Pan
authors.initials: WP
authors.lastname: To
authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Ivan F
authors.initials: IF
authors.lastname: Hung
authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Wai K
authors.initials: WK
authors.lastname: Leung
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000150:complications / Q000453:epidemiology; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000150:complications / Q000453:epidemiology; D003424:Crohn Disease / Q000150:complications / Q000453:epidemiology; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications* / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors; D014777:Virus Diseases / Q000150:complications / Q000453:epidemiology; D055815:Young Adult
keywords: Crohn's disease; hospitalization; infection; ulcerative colitis