Proton pump inhibitors as a risk factor for norovirus infection.
Norovirus causes viral gastroenteritis, which is a major problem in health care. The disease causes death in elderly and seriously ill patients, and results in significant health costs each year. Proton pump inhibitors (PPIs) reduce gastric acidity, which is an important protection against microorganisms. We hypothesised that treatment with PPIs increases the risk of contracting norovirus infection. This has not previously been studied. The study was a retrospective case-control study, in which 192 hospitalised patients positive for norovirus in Örebro County, Sweden, were identified as cases. For each case, a hospitalised patient who did not have the infection was selected as a control, and matched with respect to ward, gender, admission date and age. Details of exposure, i.e. treatment with PPIs, were retrieved from the patient records. Odds ratio (OR) with confidence intervals (CIs) and P-values were calculated using McNemar's test. There was a significantly increased risk of norovirus infection in patients treated with PPIs compared with patients without PPI treatment (OR 1·73, 95% CI 1·07-2·81; P = 0·02). PPIs appear to be a risk factor for norovirus infection, and our results motivate future studies to further examine this association.
Department of Laboratory Medicine,Örebro University Hospital,Örebro,Sweden.
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Prag
Department of Infectious Diseases,Örebro University Hospital,Örebro,Sweden.
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Prag
Department of Laboratory Medicine,Örebro University Hospital,Faculty of Medicine and Health,Örebro University,Örebro,Sweden.
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Fredlund
D000368:Aged; D000369:Aged, 80 and over; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000821:virology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000502:physiology*; D054328:Proton Pump Inhibitors / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
D054328:Proton Pump Inhibitors
Norovirus infection; proton pump inhibitors; risk factor