Major Finding: Thirty percent of 189 patients with a history of Salmonella or Campylobacter gastrointestinal infections claimed to be symptomatic for as long as 10 years after the initial infection.
Data Source: A survey of 189 individuals with a history of Salmonella or Campylobacter infection.
Disclosures: Research support was received from Zentrum für Ernaehrungsmedizin (Center of Nutritional Medicine), an interuniversity institute. Dr. Enck had no disclosures.
BOSTON – Thirty percent of individuals with a history of Salmonella or Campylobacter infections reported ongoing postinfectious symptoms as long as 10 years after the initial infectious event, according to Paul Enck, Ph.D., who presented the results in a poster at the meeting.
“These patients represent a clinically important population with high somatization, anxiety, and depression scores,” said Dr. Enck, director of research in the department of psychosomatic medicine, University Hospital Tübingen (Germany).
Surveys were sent to 576 people who had come to University Hospital Tübingen between 2000 and mid-2009 and had documented Salmonella or Campylobacter gastrointestinal infection. A total of 189 (36%) responded to the brief survey, which asked about current GI symptoms and whether respondents would be willing to participate in a further investigation of their infection history and consequences.
Of the 189 survey respondents, 56 people (30%) indicated that they were still symptomatic (end of 2009). The 56 patients included 6 patients originally infected in 2000, 5 patients infected in 2001, and 2 infected in 2002.
The average age of the respondents at the time of infection was 39.8 years, and at the time of the survey it was 43.1 years. Thirty-two patients had a history of Salmonella, and 24 had a history of Campylobacter, Dr. Enck said at the meeting, which was hosted by the American Neurogastroenterology and Motility Society.
Symptomatic individuals were then sent a second, more extensive questionnaire that focused on postinfectious irritable bowel syndrome (PI-IBS). This survey was developed and validated by the European Society of Neurogastroenterology and Motility, and is available online at www.postinfectious-ibs.eu
Ninety-one percent (51 patients) responded to the second survey. The majority of the sample (69%, or 35 patients) met criteria for PI-IBS, which includes the presence of two or more symptoms such as sudden-onset fever, diarrhea, vomiting, or bloody stools. Overall, 84% (43/51) were symptomatic during the preceding 9 months. Almost one-third (16) met Rome IBS criteria, but only 7 (14%) had met Rome IBS criteria before the infection.
No link was observed between having IBS symptoms before infection and developing PI-IBS. Neither age nor gender predicted development of PI-IBS, and no association was found between the initial bacterial strain and the risk of developing PI-IBS.
Those respondents with PI-IBS reported significantly more depression (P = .05), and had higher somatization scores than did those without PI-IBS (mean 10.6 ± 3.9 vs. 8.3 ± 3.9, not a significant difference).
“It needs to be shown whether and which individual premorbid and postinfectious clinical factors may explain symptom persistence, and whether long-term development of postinfectious symptoms may be prevented by early postinfection interventions,” noted Dr. Enck.