Pathogen-specific risk of chronic gastrointestinal disorders following bacterial causes of foodborne illness

BMC Gastroenterology

Research Article

Mark Pimentel¹  Chad K Porter²  Mark S Riddle²  Larissa May³  Daniel Choi³  Joseph Murray⁴  Brooks Cash⁵ 

[1] Cedars-Sinai Medical Center, Los Angeles, CA, USA;Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, USA;George Washington University, Washington, DC, USA;Mayo Clinic, Rochester, MN, USA;Walter Reed National Military Medical Center, Bethesda, MD, USA;

关键词: Irritable Bowel Syndrome;    Functional Dyspepsia;    Yersinia Enterocolitica;    Functional Constipation;    Enteric Infection;   

DOI  :  10.1186/1471-230X-13-46

 received in 2012-10-11, accepted in 2013-03-01,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundThe US CDC estimates over 2 million foodborne illnesses are annually caused by 4 major enteropathogens: non-typhoid Salmonella spp., Campylobacter spp., Shigella spp. and Yersinia enterocoltica. While data suggest a number of costly and morbid chronic sequelae associated with these infections, pathogen-specific risk estimates are lacking. We utilized a US Department of Defense medical encounter database to evaluate the risk of several gastrointestinal disorders following select foodborne infections.MethodsWe identified subjects with acute gastroenteritis between 1998 to 2009 attributed to Salmonella (nontyphoidal) spp., Shigella spp., Campylobacter spp. or Yersinia enterocolitica and matched each with up to 4 unexposed subjects. Medical history was analyzed for the duration of military service time (or a minimum of 1 year) to assess for incident chronic gastrointestinal disorders. Relative risks were calculated using modified Poisson regression while controlling for the effect of covariates.ResultsA total of 1,753 pathogen-specific gastroenteritis cases (Campylobacter: 738, Salmonella: 624, Shigella: 376, Yersinia: 17) were identified and followed for a median of 3.8 years. The incidence (per 100,000 person-years) of PI sequelae among exposed was as follows: irritable bowel syndrome (IBS), 3.0; dyspepsia, 1.8; constipation, 3.9; gastroesophageal reflux disease (GERD), 9.7. In multivariate analyses, we found pathogen-specific increased risk of IBS, dyspepsia, constipation and GERD.ConclusionsThese data confirm previous studies demonstrating risk of chronic gastrointestinal sequelae following bacterial enteric infections and highlight additional preventable burden of disease which may inform better food security policies and practices, and prompt further research into pathogenic mechanisms.

【 授权许可】

CC BY   
© Porter et al; licensee BioMed Central Ltd. 2013