Incidence of Campylobacter-Associated Guillain-Barre Syndrome Estimated from Health Insurance Data

被引:24
作者
Walter, Elaine J. Scallan [1 ]
Crim, Stacy M. [2 ]
Bruce, Beau B. [2 ]
Griffin, Patricia M. [2 ]
机构
[1] Colorado Sch Publ Hlth, Dept Epidemiol, 12477 E 19th Ave,M-S B119-406, Aurora, CO 80045 USA
[2] Ctr Dis Control & Prevent, Enter Dis Epidemiol Branch, Atlanta, GA USA
关键词
Campylobacter; Guillain-Barre syndrome; health insurance data; MILLER FISHER SYNDROME; UNITED-STATES; INFECTION; JEJUNI; ILLNESS; COST;
D O I
10.1089/fpd.2019.2652
中图分类号
TS2 [食品工业];
学科分类号
0832 ;
摘要
Guillain-Barre syndrome (GBS) is sometimes preceded by Campylobacter infection. We estimated the cumulative incidence of Campylobacter-associated GBS in the United States using a retrospective cohort design. We identified a cohort of patients with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code of "intestinal infection due to Campylobacter" (008.43) using MarketScan Research Databases for 2004-2013. Campylobacter patients with an encounter for "acute infective polyneuritis" (AIP; ICD-9-CM 357.0) were identified. Patients with an inpatient encounter having AIP as the principal diagnosis were considered probable GBS cases. Patients with probable GBS <= 8 weeks after the Campylobacter encounter were considered probable Campylobacter-associated GBS cases. For comparison, we repeated this analysis for patients with "other Salmonella infections" (ICD-9-CM: 003). Among 9315 Campylobacter patients, 16 met the case definition for probable GBS. Two were hospitalized with probable GBS <= 8 weeks after the encounter listing a Campylobacter diagnosis (9 and 54 days) and were considered probable cases of Campylobacter-associated GBS; this results in an estimated cumulative incidence of 21.5 per 100,000 Campylobacter patients (95% confidence interval [CI]: 3.7-86.6), or 5% of all estimated GBS cases. The remaining 14 patients were diagnosed with probable GBS on the same encounter (n = 12) or 1-3 days (n = 2), before the encounter listing the Campylobacter diagnosis. Including these cases increased the cumulative incidence to 172 per 100,000 Campylobacter cases (95% CI: 101.7-285.5), 41% of estimated GBS cases. This study, using a method not previously applied to United States data, supports other data that Campylobacter is an important contributor to GBS, accounting for at least 5% and possibly as many as 41% of all GBS cases. These data can be used to inform estimates of the burden of Campylobacter infections, including economic cost.
引用
收藏
页码:23 / 28
页数:6
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