P107 Incidence of enteric infections in symptomatic inflammatory bowel disease (IBD)

IntroductionUniversity Hospital Southampton (UHS) receives more than 8000 patient contacts via its IBD help line/online portal each year many with symptom relapse. Enteric infections mimicking an IBD flare are common with studies reporting up to 17% of symptomatic IBD patients returning positive tests.1 The aim of this project was to determine the rate of enteric infections in symptomatic IBD patients at our institution.MethodsElectronic hospital records were interrogated to identify symptomatic IBD patients contacting the IBD help line between 2015 and 2022. Patients with a confirmed IBD-subtype – Ulcerative Colitis (UC) or Crohn’s Disease (CD), who returned a valid stool sample within 30 days were included. The Chi2 statistic was calculated to estimate significance.ResultsFollowing contact to the IBD flare line with symptom relapse 1,198 individual stool samples were sent fulfilling the criteria for processing (Bristol stool type >=5) for 798 individual IBD patients (51.25% CD (n=409), 48.75% UC (n=389). Only 967/1,198(80.72%) of the samples were tested for c.difficle due to a policy change during the study period. In only 84/1,198 (7.01%) of the stool samples an enteric pathogen was detected on PCR.A full breakdown of testing results is given below in table 1.Abstract P107 Table 1Full breakdown of testing results C.Difficile PCR Campylobacter PCR Verotoxigenic E coli PCR Salmonella PCR Giardia PCR Cryptosporidium PCR CD n=22 (4.37%) n=20 (3.3%) n=1 (0.17%) n=3 (0.5%) n=1 (0.17%) n=0 (0.0%) UC n=22 (4.74%) n=11 (1.86%) n=3 (0.51%) n=0 (0.0%) n=0 (0.0%) n=1 (0.17%) p 0.90 0.16 0.60 0.26 1.0 0.99 IBD n=44 (4.55%) n=31 (2.59%) n=4 (0.33%) n=3.0 (0.25%) n=1 (0.08%) n=1 (0.08%) No significant differences were observed between the two groups. A far lower level of test positivity was observed than has been reported in previous studies.ConclusionsWe have sampled a large population of patients with inflammatory bowel disease who had submitted samples during an IBD flare. Enteric infections were less common than has previously been reported. C.diff and Campylobacter were the main 2 organisms detected. No significant differences were observed between CD and UC. This study confirms the importance of testing for enteric infection in IBD.ReferenceAxelrad JE, Joelson A, Green PH, Lawlor G, Lichtiger S, Cadwell K, Lebwohl B. Enteric infections are common in patients with flares of inflammatory bowel disease. The American Journal of Gastroenterology 2018 Oct;113(10):1530