Pathogen and Testing Profiles in Post-Infectious Irritable Bowel Syndrome Across the COVID-19 Public Health Emergency: A Retrospective Case Series
- 1Department of Internal Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, Türkiye
- 2Department of Gastroenterology, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, Türkiye
Abstract
Background/Objectives: The COVID-19 public health emergency altered enteric infection surveillance, diagnostic testing, and antibiotic prescribing. We compared pathogen/testing composition among post-infectious irritable bowel syndrome (PI-IBS) cases stratified by whether index gastroenteritis occurred before, during, or after the emergency. Methods: This single-centre retrospective case series included 138 adults with clinician-diagnosed PI-IBS classified as Rome IV-compatible by chart adjudication. Index gastroenteritis occurred from January 2019 to December 2024; existing clinical records were reviewed retrospectively. The primary comparison was a five-category pathogen/testing profile. Results: The profile differed across pre-pandemic (n = 30), pandemic (n = 39), and post-emergency (n = 69) periods (χ2 = 35.56, p < 0.001; Cramér V = 0.36, 95% CI 0.30–0.48). Bacterial/protozoal cases represented 63.3%, 7.7%, and 33.3%, respectively; SARS-CoV-2-associated cases represented 0%, 35.9%, and 13.0%. Antibiotic exposure was 56.7%, 12.8%, and 33.3%. In an exploratory adjusted model, confirmed enteric pathogens were associated with antibiotic exposure (OR 16.28, 95% CI 3.03–87.35), whereas period was not. Sensitivity analyses excluding SARS-CoV-2 cases and period-crossing diagnoses were concordant. Conclusions: Pathogen/testing and antibiotic-exposure profiles differed across periods among diagnosed PI-IBS cases. These data describe case composition, not incidence or causal risk, and cannot separate infection ecology from diagnostic behaviour.
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BibTeX
@article{bozkurt2026pathogen,
title = {{Pathogen and Testing Profiles in Post-Infectious Irritable Bowel Syndrome Across the COVID-19 Public Health Emergency: A Retrospective Case Series}},
author = {Erhan Bozkurt and Osman Sağlam and Alper Sarı and Murat Ay and Oğuzhan Köse and Alper Emre Kurt and Ali Arda Demir and Mesut Çeliker},
journal = {Journal of clinical medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15197729},
url = {https://europepmc.org/article/PMC/PMC13666457},
note = {CC BY},
}
RIS
TY - JOUR
TI - Pathogen and Testing Profiles in Post-Infectious Irritable Bowel Syndrome Across the COVID-19 Public Health Emergency: A Retrospective Case Series
AU - Erhan Bozkurt
AU - Osman Sağlam
AU - Alper Sarı
AU - Murat Ay
AU - Oğuzhan Köse
AU - Alper Emre Kurt
AU - Ali Arda Demir
AU - Mesut Çeliker
PY - 2026
DA - 2026/10/01
JO - Journal of clinical medicine
DO - 10.3390/jcm15197729
UR - https://europepmc.org/article/PMC/PMC13666457
AB - Background/Objectives: The COVID-19 public health emergency altered enteric infection surveillance, diagnostic testing, and antibiotic prescribing. We compared pathogen/testing composition among post-infectious irritable bowel syndrome (PI-IBS) cases stratified by whether index gastroenteritis occurred before, during, or after the emergency. Methods: This single-centre retrospective case series included 138 adults with clinician-diagnosed PI-IBS classified as Rome IV-compatible by chart adjudication. Index gastroenteritis occurred from January 2019 to December 2024; existing clinical records were reviewed retrospectively. The primary comparison was a five-category pathogen/testing profile. Results: The profile differed across pre-pandemic (n = 30), pandemic (n = 39), and post-emergency (n = 69) periods (χ2 = 35.56, p < 0.001; Cramér V = 0.36, 95% CI 0.30–0.48). Bacterial/protozoal cases represented 63.3%, 7.7%, and 33.3%, respectively; SARS-CoV-2-associated cases represented 0%, 35.9%, and 13.0%. Antibiotic exposure was 56.7%, 12.8%, and 33.3%. In an exploratory adjusted model, confirmed enteric pathogens were associated with antibiotic exposure (OR 16.28, 95% CI 3.03–87.35), whereas period was not. Sensitivity analyses excluding SARS-CoV-2 cases and period-crossing diagnoses were concordant. Conclusions: Pathogen/testing and antibiotic-exposure profiles differed across periods among diagnosed PI-IBS cases. These data describe case composition, not incidence or causal risk, and cannot separate infection ecology from diagnostic behaviour.
SN - 2077-0383
ER -