title: Factors Associated with Sequelae of Campylobacter and Non-typhoidal Salmonella Infections: A Systematic Review.
abstract: Despite the significant global burden of gastroenteritis and resulting sequelae, there is limited evidence on risk factors for sequelae development. We updated and extended previous systematic reviews by assessing the role of antibiotics, proton pump inhibitors (PPI) and symptom severity in the development of sequelae following campylobacteriosis and salmonellosis. We searched four databases, including PubMed, from 1 January 2011 to 29 April 2016. Observational studies reporting sequelae of reactive arthritis (ReA), Reiter's syndrome (RS), irritable bowel syndrome (IBS) and Guillain-Barré syndrome (GBS) following gastroenteritis were included. The primary outcome was incidence of sequelae of interest amongst cases of campylobacteriosis and salmonellosis. A narrative synthesis was conducted where heterogeneity was high. Of the 55 articles included, incidence of ReA (n=37), RS (n=5), IBS (n=12) and GBS (n=9) were reported following campylobacteriosis and salmonellosis. A pooled summary for each sequela was not estimated due to high level of heterogeneity across studies (I2>90%). PPI usage and symptoms were sparsely reported. Three out of seven studies found a statistically significant association between antibiotics usage and development of ReA. Additional primary studies investigating risk modifying factors in sequelae of GI infections are required to enable targeted interventions.
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom; National Institute for Health Research, Health Protection Research Unit, Gastrointestinal Infections, University of Oxford, United Kingdom. Electronic address: oluwaseun.esan@phc.ox.ac.uk.
authors.forename: Oluwaseun B
authors.initials: OB
authors.lastname: Esan
authors.affiliation: National Institute for Health Research, Health Protection Research Unit, Gastrointestinal Infections, University of Oxford, United Kingdom; Department of Zoology, University of Oxford, United Kingdom.
authors.forename: Madison
authors.initials: M
authors.lastname: Pearce
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom.
authors.forename: Oliver
authors.initials: O
authors.lastname: van Hecke
authors.affiliation: Bodleian Health Care libraries, University of Oxford, United Kingdom.
authors.forename: Nia
authors.initials: N
authors.lastname: Roberts
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom.
authors.forename: Dylan R J
authors.initials: DRJ
authors.lastname: Collins
authors.affiliation: National Institute for Health Research, Health Protection Research Unit, Gastrointestinal Infections, University of Oxford, United Kingdom; Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, United Kingdom.
authors.forename: Mara
authors.initials: M
authors.lastname: Violato
authors.affiliation: National Institute for Health Research, Health Protection Research Unit, Gastrointestinal Infections, University of Oxford, United Kingdom; Department of Zoology, University of Oxford, United Kingdom; Warwick Medical School, University of Warwick, United Kingdom.
authors.forename: Noel
authors.initials: N
authors.lastname: McCarthy
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom; National Institute for Health Research, Health Protection Research Unit, Gastrointestinal Infections, University of Oxford, United Kingdom.
authors.forename: Rafael
authors.initials: R
authors.lastname: Perera
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom; National Institute for Health Research, Health Protection Research Unit, Gastrointestinal Infections, University of Oxford, United Kingdom.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Fanshawe
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D002167:Campylobacter; D002169:Campylobacter Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005759:Gastroenteritis / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D015994:Incidence; D000091402:Prohibitins; D012307:Risk Factors; D012475:Salmonella; D012480:Salmonella Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000900:Anti-Bacterial Agents; C000717331:PHB2 protein, human; D000091402:Prohibitins
keywords: Acid suppression; Antibiotics; Campylobacter; Gastroenteritis; Salmonella; Sequelae