Systematic review and meta-analysis of the proportion of non-typhoidal Salmonella cases that develop chronic sequelae.

J Keithlin,M K Thomas,A Fazil,J M Sargeant

doi:10.1017/s0950268814002829

J Keithlin, M K Thomas + Show 2 more

Open Access

https://doi.org/10.1017/s0950268814002829

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Abstract

The objective of this systematic review and meta-analysis was to estimate the proportion of cases of non-typhoidal salmonellosis (NTS) that develop chronic sequelae, and to investigate factors associated with heterogeneity. Articles published in English prior to July 2011 were identified by searching PubMed, Agricola, CabDirect, and Food Safety and Technology Abstracts. Observational studies reporting the number of NTS cases that developed reactive arthritis (ReA), Reiter's syndrome (RS), haemolytic uraemic syndrome (HUS), irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) or Guillain-Barré syndrome (GBS), Miller-Fisher syndrome (MFS) were included. Meta-analysis was performed using random effects and heterogeneity was assessed using the I 2 value. Meta-regression was used to explore the influence of study-level variables on heterogeneity. A total of 32 studies were identified; 25 reported on ReA, five reported on RS, seven reported on IBS, two reported on IBD, two reported on GBS, one reported on MFS, and two reported on HUS. There was insufficient data in the literature to calculate a pooled estimate for RS, HUS, IBD, GBS, or MFS. The pooled estimate of the proportion of cases of NTS that developed ReA and IBS had substantive heterogeneity, limiting the applicability of a single estimate. Thus, these estimates should be interpreted with caution and reasons for the high heterogeneity should be further explored.

Highlights

The purpose of this systematic review and meta-analysis was to estimate the proportion of cases of non-typhoidal salmonellosis (NTS) that develop reactive arthritis (ReA) or Reiter’s syndrome (RS), Guillain–Barré syndrome (GBS), Miller Fisher syndrome (MFS), irritable bowel syndrome (IBS), haemolytic uraemic syndrome (HUS), inflammatory bowel disease (IBD) including ulcerative colitis (UC), and Crohn’s disease (Crohn’s) and to use meta-regression to explore the study-level variables that contributed to variation in estimates
This paper presents results for Salmonella and the chronic sequelae of ReA including RS, IBS, IBD including UC and Crohn’s, GBS including Miller–Fisher syndrome (MFS), and HUS
Seventeen were based on outbreaks and of those that reported source (n = 16) all but one were foodborne and 44% (7/16) of those were attributed to contaminated meat

Summary

SUMMARY

The objective of this systematic review and meta-analysis was to estimate the proportion of cases of non-typhoidal salmonellosis (NTS) that develop chronic sequelae, and to investigate factors associated with heterogeneity. A total of 32 studies were identified; 25 reported on ReA, five reported on RS, seven reported on IBS, two reported on IBD, two reported on GBS, one reported on MFS, and two reported on HUS. There was insufficient data in the literature to calculate a pooled estimate for RS, HUS, IBD, GBS, or MFS. The pooled estimate of the proportion of cases of NTS that developed ReA and IBS had substantive heterogeneity, limiting the applicability of a single estimate. These estimates should be interpreted with caution and reasons for the high heterogeneity should be further explored

INTRODUCTION

MATERIALS AND METHODS

RESULTS

Summary estimate

DISCUSSION

CONCLUSION