Helms Morten, Simonsen Jacob, Mølbak Kåre
Department of Epidemiology Research, Danish Epidemiology Science Center, Copenhagen, Denmark.
Clin Infect Dis. 2006 Feb 15;42(4):498-506. doi: 10.1086/499813. Epub 2006 Jan 17.
Foodborne bacterial gastrointestinal infections are important causes of morbidity and mortality worldwide, and despite successful control programs in some developed countries, these infections continue to have a major impact on public health and economy.
On the basis of data from 3 national registries, we determined short- and long-term risks of hospitalization due to gastroenteritis, short-term complications, and long-term sequelae after infections with nontyphoid Salmonella enterica, Campylobacter species, Yersinia enterocolitica, diarrheagenic Escherichia coli, and Shigella species.
Among 52,121 patients, 7524 (14.4%) were hospitalized with a diagnosis of gastroenteritis within 90 days after microbiological diagnosis. A total of 4941 patients (17.7%) with infections due to S. enterica and 1937 (10.8%) with infections due to Campylobacter species were admitted to the hospital. Complications, such as gastrointestinal perforation and invasive illness, occurred in 647 patients (1.2%). The risk of invasive illness was > 6-fold higher in patients with infections due to S. enterica (odds ratio [OR] compared with the general population, 30.3; 95% confidence interval [CI], 26.2-35.1) than in those with infections due to Campylobacter species (OR, 4.9; 95% CI, 3.5-6.8) (P < .001). Long-term sequelae were seen in 865 patients (1.7%). Among 1000 patients with infections due to S. enterica, 1820 days of hospital stay were attributable to gastroenteritis, complications, and long-term sequelae. The corresponding figure for Campylobacter infections was 714 days.
Infections with bacteria that are usually foodborne cause considerable morbidity, in terms of severe gastroenteritis that requires admission to hospital, as well as complications and long-term sequelae. The risk of complications and sequelae depends on bacterial species, and nontyphoid Salmonella is particularly associated with a burden of severe morbidity.
食源性细菌性胃肠道感染是全球发病和死亡的重要原因,尽管一些发达国家实施了成功的防控计划,但这些感染仍对公众健康和经济产生重大影响。
基于3个国家登记处的数据,我们确定了非伤寒型肠炎沙门氏菌、弯曲杆菌属、小肠结肠炎耶尔森菌、致泻性大肠杆菌和志贺氏菌感染后因肠胃炎住院的短期和长期风险、短期并发症以及长期后遗症。
在52121例患者中,7524例(14.4%)在微生物学诊断后90天内因肠胃炎诊断住院。共有4941例(17.7%)肠炎沙门氏菌感染患者和1937例(10.8%)弯曲杆菌属感染患者入院。647例患者(1.2%)出现胃肠道穿孔和侵袭性疾病等并发症。肠炎沙门氏菌感染患者发生侵袭性疾病的风险比弯曲杆菌属感染患者高6倍以上(与普通人群相比,比值比[OR]为30.3;95%置信区间[CI]为26.2 - 35.1),而弯曲杆菌属感染患者的OR为4.9;95%CI为3.5 - 6.8(P <.001)。865例患者(1.7%)出现长期后遗症。在1000例肠炎沙门氏菌感染患者中,1820天的住院时间归因于肠胃炎、并发症和长期后遗症。弯曲杆菌感染对应的数字为714天。
通常通过食物传播的细菌感染会导致相当高的发病率,表现为需要住院治疗的严重肠胃炎、并发症以及长期后遗症。并发症和后遗症的风险取决于细菌种类,非伤寒型沙门氏菌尤其与严重发病负担相关。