Foodborne bacterial infection and hospitalization: A registry-based study

Background. Foodborne bacterial gastrointestinal infections are important causes of morbidity and mortality worldwide, and despite successful control programs in some developed countries, these infections continue to have a major impact on public health and economy. Methods. On the basis of data from 3 national registries, we determined short- and long-term risks of hospitalization due to gastroenteritis, short- term complications, and long-term sequelae after infections with non-typhoid Salmonella enterica, Campylobacter species, Yersinia enterocolitica, diarrheagenic Escherichia coli, and Shigella species. Results. Among 52,121 patients, 7524 (14.4%) were hospitalized with a diagnosis of gastroenteritis within 90 days after microbiological diagnosis. A total of 4941 patients (17.7%) with infections due to S. enterica and 1937 (10.8%) with infections due to Campylobacter species were admitted to the hospital. Complications, such as gastrointestinal perforation and invasive illness, occurred in 647 patients (1.2%). The risk of invasive illness was >6-fold higher in patients with infections due to S. enterica ( odds ratio [ OR] compared with the general population, 30.3; 95% confidence interval [CI], 26.2 - 35.1) than in those with infections due to Campylobacter species ( OR, 4.9; 95% CI, 3.5 - 6.8) (P<.001). Long-term sequelae were seen in 865 patients (1.7%). Among 1000 patients with infections due to S. enterica, 1820 days of hospital stay were attributable to gastroenteritis, complications, and long-term sequelae. The corresponding figure for Campylobacter infections was 714 days. Conclusions. Infections with bacteria that are usually foodborne cause considerable morbidity, in terms of severe gastroenteritis that requires admission to hospital, as well as complications and long-term sequelae. The risk of complications and sequelae depends on bacterial species, and nontyphoid Salmonella is particularly associated with a burden of severe morbidity.