| アブストラクト | BACKGROUND: Reactive arthritis, irritable bowel syndrome (IBS), Guillain-Barre syndrome, ulcerative colitis, and Crohn's disease may be sequelae of Campylobacter or non-typhoidal Salmonella (NTS) infections. Proton pump inhibitors (PPI) and antibiotics may increase the risk of gastrointestinal infections (GII); however, their impact on sequelae onset is unclear. We investigated the incidence of sequelae, their association with antibiotics and PPI prescription, and assessed the economic impact on the NHS. METHODS: Data from the Clinical Practice Research Datalink for patients consulting their GP for Campylobacter or NTS infection, during 2000-2015, were linked to hospital, mortality, and Index of Multiple Deprivation data. We estimated the incidence of sequelae and deaths in the 12 months following GII. We conducted logistic regression modelling for the adjusted association with prescriptions. We compared differences in resource use and costs pre- and post-infection amongst patients with and without sequelae. FINDINGS: Of 20,471 patients with GII (Campylobacter 17,838), less than 2% (347) developed sequelae, with IBS (268) most common. Amongst Campylobacter patients, those with prescriptions for PPI within 12 months before and cephalosporins within 7-days before/after infection had elevated risk of IBS (adjusted odds ratio [aOR] 2.1, 1.5-2.9) and (aOR 3.6, 1.1-11.7) respectively. Campylobacter sequelae led to approximately pound1.3 million, ( pound750,000, pound1.7 million) in additional annual NHS expenditure. INTERPRETATION: Sequelae of Campylobacter and NTS infections are rare but associated with increased NHS costs. Prior prescription of PPI may be a modifiable risk factor. Incidence of sequelae, healthcare resource use and costs are essential parameters for future burden of disease studies. |
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| ジャーナル名 | The Journal of infection |
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| Pubmed追加日 | 2020/5/24 |
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| 投稿者 | Esan, Oluwaseun B; Perera, Rafael; McCarthy, Noel; Violato, Mara; Fanshawe, Thomas R |
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| 組織名 | Nuffield Department of Primary Health Care Sciences, University of Oxford,;Oxford, OX2 6GG, United Kingdom; NIHR Health Protection Research Unit,;Gastrointestinal Infections Theme, University of Oxford, Oxford, United Kingdom.;Electronic address: oluwaseun.esan@phc.ox.ac.uk.;NIHR Health Protection Research Unit, Gastrointestinal Infections Theme,;University of Oxford, Oxford, United Kingdom; Warwick Medical School, University;of Warwick, Coventry, CV4 7AL, United Kingdom.;University of Oxford, Oxford, United Kingdom; Health Economics Research Centre,;Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF,;United Kingdom. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/32445725/ |
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