{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T23:14:40Z","timestamp":1764890080859,"version":"3.46.0"},"reference-count":28,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"unspecified","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010804","name":"Faculty of Medicine, Prince of Songkla University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,21]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To compare colorectal neoplasm detection rates between patients with\n                      <jats:italic>Streptococcus gallolyticus<\/jats:italic>\n                      septicaemia and average-risk individuals undergoing screening colonoscopy and identify predictors of neoplasm detection within the septicaemia group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective matched cohort study<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary care university hospital in Southern Thailand.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Eighty-five patients with\n                      <jats:italic>S. gallolyticus<\/jats:italic>\n                      septicaemia and 279 average-risk individuals who underwent colonoscopy between 2014 and 2024.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Outcomes included the polyp detection rate (PDR), adenoma detection rate (ADR), advanced adenoma detection rate (aADR) and adenocarcinoma detection rate. Logistic regression was used to estimate ORs with 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In an unmatched analysis, the ADR (41.2% vs 26.9%, OR 1.90, 95%\u2009CI 1.15 to 3.16, p=0.014) and adenocarcinoma detection rate (12.9% vs 2.9%, OR 5.04, 95%\u2009CI 1.95 to 12.97, p&lt;0.001) were significantly higher in the septicaemia group, whereas the PDR and aADR were not significantly different. In the age- and sex-matched analysis (n=50 pairs), detection rates were comparable, except for a lower PDR in the septicaemia group (44% vs 70%, OR 0.34, 95%\u2009CI 0.14 to 0.76, p=0.008). Subgroup analysis within the septicaemia group identified older age (adjusted OR 1.04 per year, 95%\u2009CI 1.01 to 1.08, p=0.023) and diabetes mellitus (adjusted OR 2.79, 95%\u2009CI 1.15 to 6.81, p=0.034) as independent predictors of colonic neoplasm detection. Importantly, colonoscopy performed\n                      <jats:bold>after<\/jats:bold>\n                      the septicaemia episode was independently associated with a markedly higher likelihood of neoplasm detection than procedures done\n                      <jats:bold>before<\/jats:bold>\n                      septicaemia (adjusted OR 4.88, 95%\u2009CI 1.70 to 14.05, p=0.002), indicating that repeat colonoscopy may be warranted even in patients who had undergone the procedure within the previous 6 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic>S. gallolyticus<\/jats:italic>\n                      septicaemia was linked to higher adenoma and adenocarcinoma detection rates, with age and diabetes mellitus further increasing such risk. Even patients who underwent colonoscopy within 6 months before septicaemia benefited from repeat colonoscopy, supporting its consideration to prevent missed or rapidly developing lesions.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-103612","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T10:25:30Z","timestamp":1760437530000},"page":"e103612","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Colonic neoplasm detection in patients with\n                    <i>Streptococcus gallolyticus<\/i>\n                    septicaemia versus average-risk individuals: a retrospective matched cohort study from a tertiary care center in 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