Abstract
Despite the significant global burden of gastroenteritis and resulting sequelae, there is limited evidence on risk factors for sequelae development. We updated and extended previous systematic reviews by assessing the role of antibiotics, proton pump inhibitors (PPI) and symptom severity in the development of sequelae following campylobacteriosis and salmonellosis. We searched four databases, including PubMed, from 1 January 2011 to 29 April 2016. Observational studies reporting sequelae of reactive arthritis (ReA), Reiter's syndrome (RS), irritable bowel syndrome (IBS) and Guillain-Barré syndrome (GBS) following gastroenteritis were included. The primary outcome was incidence of sequelae of interest amongst cases of campylobacteriosis and salmonellosis. A narrative synthesis was conducted where heterogeneity was high. Of the 55 articles included, incidence of ReA (n=37), RS (n=5), IBS (n=12) and GBS (n=9) were reported following campylobacteriosis and salmonellosis. A pooled summary for each sequela was not estimated due to high level of heterogeneity across studies (I2>90%). PPI usage and symptoms were sparsely reported. Three out of seven studies found a statistically significant association between antibiotics usage and development of ReA. Additional primary studies investigating risk modifying factors in sequelae of GI infections are required to enable targeted interventions.
Highlights
Campylobacter and non-typhoidal Salmonella enterica (NTS) are important agents of human bacterial gastroenteritis, representing over 30% (174.3 million) of diarrhoeal illnesses globally in 2010
Data was extracted from all five studies and additional studies from the previous systematic reviews on reactive arthritis (ReA), Reiter's Syndrome (RS), irritable bowel syndrome (IBS) and Guillain-Barré Syndrome (GBS) following GI infections (n = 50)
No eligible studies on Inflammatory Bowel Disease (IBD), Crohn's disease (CD) and ulcerative colitis (UC) were identified by our database search, so these sequelae are not considered further in this review
Summary
Campylobacter and non-typhoidal Salmonella enterica (NTS) are important agents of human bacterial gastroenteritis, representing over 30% (174.3 million) of diarrhoeal illnesses globally in 2010. Foodborne disease burden is not distributed amongst the World Health Organisation (WHO) sub regions, with the greatest burden falling on the sub regions in Africa. Both Campylobacter and NTS ( gastrointestinal (GI) infections) still pose a. A subset of patients develop sequelae such as reactive arthritis (ReA), Reiter's Syndrome (RS), irritable bowel syndrome (IBS), Guillain-Barré Syndrome (GBS), Inflammatory Bowel Disease (IBD), Crohn's disease (CD) and ulcerative colitis (UC) (Ajene et al, 2013; Keithlin et al, 2014, 2015)
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