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. 2013 Mar 8:13:46.
doi: 10.1186/1471-230X-13-46.

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

Chad K Porter  1 , Daniel Choi, Brooks Cash, Mark Pimentel, Joseph Murray, Larissa May, Mark S Riddle
Affiliations

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

Chad K Porter et al. BMC Gastroenterol. .

Abstract

Background: The 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.

Methods: We 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.

Results: A 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.

Conclusions: These 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.

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Figures

Figure 1
Figure 1
Time to IBS onset following documented bacillary diarrhea attributable to Salmonella, Campylobacter, Shigella, and Yersinia among active duty U.S. military personnel from 1998 to 2009.
See this image and copyright information in PMC

References

    1. Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM. Foodborne illness acquired in the United States–unspecified agents. Emerg Infect Dis. 2011;17(1):16–22. doi: 10.3201/eid1701.P21101. - DOI - PMC - PubMed
    1. Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, Jones JL, Griffin PM. Foodborne illness acquired in the United States–major pathogens. Emerg Infect Dis. 2011;17(1):7–15. - PMC - PubMed
    1. Ford AC, Thabane M, Collins SM, Moayyedi P, Garg AX, Clark WF, Marshall JK. Prevalence of uninvestigated dyspepsia 8 years after a large waterborne outbreak of bacterial dysentery: a cohort study. Gastroenterology. 2010;138(5):1727–1736. doi: 10.1053/j.gastro.2010.01.043. quiz e1712. - DOI - PubMed
    1. Mearin F. Postinfectious functional gastrointestinal disorders. J Clin Gastroenterol. 2011;45(Suppl):S102–S105. - PubMed
    1. Mearin F, Perello A, Balboa A, Perona M, Sans M, Salas A, Angulo S, Lloreta J, Benasayag R, Garcia-Gonzalez MA. Pathogenic mechanisms of postinfectious functional gastrointestinal disorders: results 3 years after gastroenteritis. Scand J Gastroenterol. 2009;44(10):1173–1185. doi: 10.1080/00365520903171276. - DOI - PubMed

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