Bacterial Enteritis as a Risk Factor for Childhood Intussusception: A Retrospective Cohort Study
Received 5 February 2009; received in revised form 14 October 2009; accepted 9 November 2009. published online 08 February 2010.
Objective
To assess the relationship between bacterial enteritis and intussusception.
Study design
The Patient Administration Systems and Biostatistics Activity database from January 2002 to December 2005 was examined for clinic visits or hospital admission to a Department of Defense medical facility for children age 0-5 years. The study included the International Statistical Classification of Diseases and Related Health Problems diagnosis-related group (DRG) codes for infections with Yersinia enterocolitica, Escherichia coli, Shigella species, Salmonella species, and Campylobacter. Identified patients were then assessed for the intussusception DRG code for 0-180 days postinfection. The total number of children enrolled in military treatment facilities in the same age group (denominator) was obtained.
Results
Bacterial enteritis significantly increased the relative risk of intussusception. An increased risk was found following infection with Salmonella, E coli, Shigella, and Campylobacter. The relative risk for intussusception following any bacterial enteritis was 40.6 (95% confidence interval = 28.6-57.5; P < .0001).
Conclusions
Bacterial enteritis is a significant risk factor for the subsequent development of intussusception in children.
aAir Force Institute of Technology Wright Patterson Air Force Base, Cincinnati, OH
bDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
cDepartment of Pediatrics, University of New Mexico Children's Hospital, Albuquerque, NM
Reprint requests: Cade M. Nylund, MD, Cincinnati Children's Hospital Medical Center, ML 2010, 3333 Burnet Ave, Cincinnati, OH 45229-3039.
The authors declare no conflicts of interest. The views expressed in this article are those of the authors and do not reflect the official policy or position of the US Air Force, Department of Defense, or the US Government.
ABSTRACT