Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA.
Enteric Diseases Epidemiology Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Am J Gastroenterol. 2019 Oct;114(10):1649-1656. doi: 10.14309/ajg.0000000000000408.
Postinfectious irritable bowel syndrome (PI-IBS) is an important sequela of Campylobacter infection. Our goal is to estimate the incidence of Campylobacter-associated PI-IBS in the United States.
Data from January 1, 2010 to December 31, 2014, were obtained from the MarketScan Research Commercial Claims and Encounters Database. We identified patients with an encounter that included an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for "intestinal infection due to Campylobacter" (008.43) and individually matched them (on age group, sex, and length of enrollment) to a group of persons without a diagnosed Campylobacter infection (non-cases). The primary outcome of interest was a new diagnosis of IBS (International Classification of Diseases, Ninth Revision, Clinical Modification 564.1).
Our final matched cohort included 4,143 cases and 20,491 non-cases. At 1 year, the incidence rate of IBS was 33.1 and 5.9 per 1,000 among cases and non-cases, respectively, with an unadjusted risk ratio of 5.6 (95% confidence interval [CI]: 4.3-7.3). After adjusting for healthcare utilization, the Cox proportional hazard ratio was 4.6 (95% CI: 3.5-6.1). Excluding those who received an IBS diagnosis within 90 days, the 1-year incidence rate of IBS was 16.7 and 3.9 per 1,000 among cases and non-cases, respectively, with an unadjusted risk ratio of 4.3 (95% CI: 3.0-6.2).
Persons with a Campylobacter infection have a much higher risk of developing IBS compared with those not diagnosed with Campylobacter infection. The burden of Campylobacter-associated PI-IBS should be considered when assessing the overall impact of Campylobacter infections.
感染后肠易激综合征（PI-IBS）是弯曲杆菌感染的重要后遗症。我们的目标是估计美国弯曲杆菌相关 PI-IBS 的发病率。
我们从 2010 年 1 月 1 日至 2014 年 12 月 31 日期间的 MarketScan 研究商业索赔和遭遇数据库中获取数据。我们确定了在就诊时有弯曲杆菌感染（008.43）国际疾病分类，第九修订版，临床修正诊断代码的患者，并对他们进行了个体匹配（年龄组，性别和登记长度）至一组未诊断出弯曲杆菌感染的人（非病例）。主要观察结果是新诊断为 IBS（国际疾病分类，第九修订版，临床修正 564.1）。
我们最终的匹配队列包括 4143 例病例和 20491 例非病例。在 1 年内，IBS 的发病率为 33.1 和 5.9 / 1000 人，分别在病例和非病例中，未调整的风险比为 5.6（95％置信区间[CI]：4.3-7.3）。调整医疗保健利用率后，Cox 比例风险比为 4.6（95％CI：3.5-6.1）。排除 90 天内诊断出 IBS 的患者后，IBS 的 1 年发病率为 16.7 和 3.9 / 1000 人，分别在病例和非病例中，未调整的风险比为 4.3（95％CI：3.0-6.2）。
与未诊断出弯曲杆菌感染的患者相比，患有弯曲杆菌感染的患者患 IBS 的风险高得多。在评估弯曲杆菌感染的总体影响时，应考虑与弯曲杆菌相关的 PI-IBS 的负担。
