and Long-Term Risk of Inflammatory Bowel Disease After Salmonella or
of Article: http://www.foodpoisonjournal.com/
Kim O. Gradel, Hans L.
Nielsen, Henrik C. Schønheyder, Tove Ejlertsen, Brian Kristensen, Henrik
Nielsen, Received 12 December 2008; accepted 2 April 2009. published
online 09 April 2009. Gastroenterology August 2009 (Vol. 137, Issue 2,
enteric and potentially pathogenic bacteria may be involved in the
pathogenesis of inflammatory bowel diseases (IBD). We compared the risk
of IBD between a cohort of patients with documented Salmonella or
Campylobacter gastroenteritis and an age- and gender-matched control
group from the same population in Denmark.
We identified 13,324
patients with Salmonella/Campylobacter gastroenteritis from laboratory
registries in North Jutland and Aarhus counties, Denmark, from 1991
through 2003, and 26,648 unexposed controls from the same counties. Of
these, 176 exposed patients with IBD before the infection, their 352
unexposed controls, and 80 unexposed individuals with IBD before the
Salmonella/Campylobacter infection were excluded. The final study cohort
of 13,148 exposed and 26,216 unexposed individuals were followed for up
to 15 years (mean, 7.5 years).
A first-time diagnosis
of IBD was reported in 107 exposed (1.2%) and 73 unexposed individuals
(0.5%). By age, gender, and comorbidity adjusted Cox proportional hazards
regression analysis, the hazard ratio (95% confidence interval) for IBD
was 2.9 (2.2–3.9) for the whole period and 1.9 (1.4–2.6) if the first
year after the Salmonella/Campylobacter infection was excluded. The
increased risk in exposed subjects was observed throughout the 15-year
observation period. The increased risk was similar for Salmonella (n =
6463) and Campylobacter (n = 6685) and for a first-time diagnosis of
Crohn's disease (n = 47) and ulcerative colitis (n = 133).
In our population-based
cohort study with complete follow-up, an increased risk of IBD was
demonstrated in individuals notified in laboratory registries with an
episode of Salmonella/Campylobacter gastroenteritis.