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

Authors

Chad K. Porter, United States Navy
Daniel Choi, George Washington University
Brooks Cash, Walter Reed National Military Medical Center, Bethesda, MD
Mark Pimentel, Cedars Sinai Medical Center, Los Angeles, CA
Joseph Murray, Mayo Clinic, Rochester, MN
Larissa May, George Washington UniversityFollow
Mark S. Riddle, United States Navy

Document Type

Journal Article

Publication Date

3-8-2013

Journal

BMC Gastroenterology

Volume

Volume 13, Issue 46

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.

Comments

Reproduced with permission of BioMed Central Gastroenterology.

Creative Commons License

This work is licensed under a Creative Commons Attribution 3.0 License.

APA Citation

Porter, C.K., Choi, D., Cash, B., Pimentel, M.,Murray, J., May, L., Riddle, M.S. (2013). Pathogen-specific risk of chronic gastrointestinal disorders following bacterial causes of foodborne illness. BMC Gastroenterology, 13(46).

Peer Reviewed

1

Open Access

1