title: Association between recent use of proton pump inhibitors and nontyphoid salmonellosis: a nested case-control study.
abstract: BACKGROUND
  The association between proton pump inhibitors (PPIs) and nontyphoid salmonellosis (NTS) continues to be debated. The current study was designed to determine the association between use of oral PPIs and the diagnosis of NTS.
  
  
  METHODS
  The Taiwan National Health Insurance Research Database from 2000 to 2010 was searched for cases of NTS, defined by the International Classification of Disease, Ninth revision, Clinical Modification. A nested case-control study in hospitalized population was conducted using 4 controls for each case patient (14 736 case patients and 58 944 controls), matched for age, month and year of entry, Charlson comorbidity index score, and well-known predisposing factors for NTS, including autoimmune diseases, acquired immunodeficiency syndrome, diabetes, cirrhosis, transplantation, gastrointestinal operations or diseases, and malignancies.
  
  
  RESULTS
  Persons with NTS had a higher rate of using oral PPIs within the prior year (adjusted odds ratio [OR], 2.09; 95% confidence interval [CI], 1.95-2.24; P < .001). The association was greatest for current PPI use (adjusted OR, 5.39; 95% CI, 4.79-6.06; P < .001). Although use of H2-receptor antagonists (adjusted OR, 1.84; 95% CI, 1.71-1.98), antibiotics (5.21; 4.81-5.64), steroids (3.18; 2.99-3.39), and nonsteroidal anti-inflammatory drugs (2.37; 2.26-2.48) within the 30 days were also associated with NTS, the linkage between PPI use and NTS remained significant in the subgroup without these medications.
  
  
  CONCLUSIONS
  The use of oral PPIs was associated with the occurrence of NTS. The risk waned with time after discontinuation.
authors.affiliation: Office of Preventive Medicine, Centers for Disease Control, Taipei.
authors.forename: Hau-Hsin
authors.initials: HH
authors.lastname: Wu
authors.affiliation: Divisions of Nephrology, Taipei Veterans General Hospital Department of Medicine, Taipei City Hospital Heping Fuyou Branch.
authors.forename: Yung-Tai
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Department of Medicine, Taipei Veterans General Hospital, Yuanshan Branch, Yilan School of Medicine, National Yang-Ming University.
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Shih
authors.affiliation: Institutes of Clinical Medicine, School of Medicine, National Yang-Ming University Emergency Department, Taipei Veterans General Hospital.
authors.forename: Yi-Tzu
authors.initials: YT
authors.lastname: Lee
authors.affiliation: Institutes of Clinical Medicine, School of Medicine, National Yang-Ming University National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan Township, Miaoli County.
authors.forename: Shu-Chen
authors.initials: SC
authors.lastname: Kuo
authors.affiliation: Institutes of Clinical Medicine, School of Medicine, National Yang-Ming University Cheng Hsin General Hospital, Taipei, Taiwan.
authors.forename: Te-Li
authors.initials: TL
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D012480:Salmonella Infections / Q000139:chemically induced / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology
chemical_list: D054328:Proton Pump Inhibitors
keywords: nontyphoid salmonellosis; proton pump inhibitors; risks
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