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. 2009 Feb 15;199(4):467-76.
doi: 10.1086/596555.

Tri-county comprehensive assessment of risk factors for sporadic reportable bacterial enteric infection in children

Donna M Denno  1 , William E Keene, Carolyn M Hutter, Jennifer K Koepsell, Marianne Patnode, Denny Flodin-Hursh, Laurie K Stewart, Jeffrey S Duchin, Laurette Rasmussen, Robert Jones, Phillip I Tarr
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Tri-county comprehensive assessment of risk factors for sporadic reportable bacterial enteric infection in children

Donna M Denno et al. J Infect Dis. .

Abstract

Background: The aim of this study was to determine risk factors for childhood sporadic reportable enteric infection (REI) caused by bacteria, specifically Campylobacter, Salmonella, Escherichia coli O157, or Shigella (REI-B).

Methods: Matched case-control study. Case patients aged <19 years who were reported to 3 Washington State county health departments and matched control subjects were interviewed from November 2003-November 2005. Matched odds ratios (ORs) were calculated by using conditional logistic regression. Population attributable risk percentages were calculated for exposures associated with infection.

Results: Two hundred ninety-six case patients were matched to 580 control subjects. Aquatic recreation was the most important factor associated with all REI-Bs studied (beach water exposure [OR for Salmonella infection, 28.3 {CI, 7.2-112.2}; OR for Shigella infection, 14.5 {CI 1.5-141.0} or any recreational water exposure [OR for Campylobacter infection, 2.7 {CI, 1.5-4.8}; OR for Escherichia coli O157 infection, 7.4 {CI, 2.1-26.1}]). Suboptimal kitchen hygiene after preparation of raw meat or chicken (OR, 7.1 [CI, 2.1-24.1]) and consumption of food from restaurants were additional risks for Campylobacter infection. Infection with Salmonella was associated with the use of private wells as sources of drinking water (OR, 6.5 [CI, 1.4-29.7]), and the use of residential septic systems was a risk for both Salmonella (OR, 3.2 [CI, 1.3-7.8]) and E. coli (OR, 5.7 [CI, 1.2-27.2]) O157 infection.

Conclusions: Overall, non-food exposures were as important as food-related exposures with regard to their contributions to the proportion of cases. Infection prevention efforts should address kitchen hygiene practices and non-food exposures, such as recreational water exposure, in addition to food-consumption risks.

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Figures

Figure 1.
Figure 1.
Study enrollment of case patients with laboratory-confirmed reportable enteric infection caused by bacteria (REI-B). Numbers in parentheses are no. of participants. See Methods for details about exclusion criteria.
Table 1.
Table 1.
Exposure variables evaluated in pathogen-specific questionnaires administered to case patients and control subjects.
Table 2.
Table 2.
Demographic characteristics of participating and nonparticipating case patients.
Table 3.
Table 3.
Demographic characteristics of participating case patients and control subjects, according to pathogen infecting the case patient.
Table 4.
Table 4.
Univariate and multivariate analysis of selected risk factors for sporadic reportable enteric infection caused by bacteria.
Table 5.
Table 5.
Univariate and multivariate analysis of categorical variables associated with Campylobacter infection.
Table 6.
Table 6.
Population attributable risk percentages for sporadic reportable enteric infection caused by bacteria.
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References

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