Infektionen bei chronisch-entzündlichen Darmerkrankungen

 

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Zusammenfassung

Infektionen tragen entscheidend zu Morbidität und Mortalität bei CED bei. Neben Malnutrition, Komorbiditäten und dem Patientenalter stellt insbesondere die immunsuppressive Therapie einen Risikofaktor für opportunistische Infektionen dar. Während das mit Kortikosteroiden, Thiopurinen und TNFα-Antikörpern verbundene Infektionsrisiko in populationsbasierten Studien untersucht wurde, existieren bislang nur wenige Daten zum Infektionsrisiko unter darmselektiven Integrin-Antikörpern. Darüber hinaus existieren widersprüchliche Daten zum Infektionsrisiko unter einer immunsuppressiven Kombinationstherapie. Klinische Bedeutung kommt dem infektiologischen Screening vor medikamentöser Immunsuppression und der Abgrenzung des akuten CED-Schubes von intestinalen Infektionen zu.

Abstract

Infections significantly contribute to morbidity and mortality in inflammatory bowel diseases (IBD). Major risk factors for opportunistic infections in IBD include malnutrition, comorbidities, age and immunosuppression. While the risk of infection associated with corticosteroids, thiopurines, and TNFα antibodies has been determined in large, population-based studies, less is known about the risk associated with antibodies targeting gut-selective integrins. Furthermore, controversial data exist regarding the risk of infection under combined immunosuppression. In clinical practice, screening for infectious diseases before medical immunosuppression and delineation of disease flares from infectious complications remains of critical importance.

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