Characteristics of Campylobacter and Salmonella Infections and Acute Gastroenteritis in Older Adults in Australia, Canada, and the United States.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
15 10 2019
Historique:
received: 18 09 2018
accepted: 31 12 2018
pubmed: 3 1 2019
medline: 15 9 2020
entrez: 3 1 2019
Statut: ppublish

Résumé

The early detection of enteric infections in older adults is challenging because typical signs and symptoms of disease may be less common, absent, or overlooked. Understanding illness characteristics of enteric infections among older adults could improve the timeliness and accuracy of clinical diagnoses, thereby improving patient outcomes and increasing cases reported to surveillance. Here, we describe illness characteristics (percentage reporting bloody diarrhea, fever, vomiting, abdominal pain; percentage hospitalized; duration of hospitalization; and duration of illness) among older adults (≥65 years) with acute gastroenteritis and culture-confirmed Campylobacter and nontyphoidal Salmonella infections in Australia, Canada, and the United States and compare these characteristics with those among younger people (<5 years, 5-24 years, and 25-64 years). A significant negative correlation was found between all symptoms and increasing age group, except for bloody diarrhea in cases of acute gastroenteritis. Adults aged ≥85 years reported bloody diarrhea in only 9% of nontyphoidal Salmonella and 4% of Campylobacter infections compared with 59% and 55% among children aged <5 years. Conversely, a greater percentage of older adults (≥65) than younger persons (<5, 5-24, 25-64) reported being hospitalized, with an increasing linear relationship in age groups 65 years and older. Although older adults are more likely to have severe illness and be hospitalized, we found that the proportion of persons reporting symptoms typically associated with enteric infections decreases with age. These findings have implications for clinical recognition and treatment of gastrointestinal illness, as well as for public health research.

Sections du résumé

BACKGROUND
The early detection of enteric infections in older adults is challenging because typical signs and symptoms of disease may be less common, absent, or overlooked. Understanding illness characteristics of enteric infections among older adults could improve the timeliness and accuracy of clinical diagnoses, thereby improving patient outcomes and increasing cases reported to surveillance.
METHODS
Here, we describe illness characteristics (percentage reporting bloody diarrhea, fever, vomiting, abdominal pain; percentage hospitalized; duration of hospitalization; and duration of illness) among older adults (≥65 years) with acute gastroenteritis and culture-confirmed Campylobacter and nontyphoidal Salmonella infections in Australia, Canada, and the United States and compare these characteristics with those among younger people (<5 years, 5-24 years, and 25-64 years).
RESULTS
A significant negative correlation was found between all symptoms and increasing age group, except for bloody diarrhea in cases of acute gastroenteritis. Adults aged ≥85 years reported bloody diarrhea in only 9% of nontyphoidal Salmonella and 4% of Campylobacter infections compared with 59% and 55% among children aged <5 years. Conversely, a greater percentage of older adults (≥65) than younger persons (<5, 5-24, 25-64) reported being hospitalized, with an increasing linear relationship in age groups 65 years and older.
CONCLUSIONS
Although older adults are more likely to have severe illness and be hospitalized, we found that the proportion of persons reporting symptoms typically associated with enteric infections decreases with age. These findings have implications for clinical recognition and treatment of gastrointestinal illness, as well as for public health research.

Identifiants

pubmed: 30602004
pii: 5270126
doi: 10.1093/cid/ciy1142
pmc: PMC6606397
mid: NIHMS1028492
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

1545-1552

Subventions

Organisme : Intramural CDC HHS
ID : CC999999
Pays : United States
Organisme : OSELS CDC HHS
ID : U60 OE000103
Pays : United States

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Références

Clin Infect Dis. 2008 Aug 1;47(3):392-400
pubmed: 18558879
Eur J Clin Microbiol Infect Dis. 2012 Aug;31(8):1895-900
pubmed: 22228374
J Am Geriatr Soc. 2006 Apr;54(4):680-4
pubmed: 16686882
Clin Infect Dis. 2010 Feb 1;50(3):397-404
pubmed: 20047497
Foodborne Pathog Dis. 2015 Jun;12(6):492-9
pubmed: 26067228
Epidemiol Infect. 2007 Feb;135(2):293-301
pubmed: 17291364
MMWR Morb Mortal Wkly Rep. 2014 Apr 18;63(15):328-32
pubmed: 24739341
Emerg Infect Dis. 2014 Nov;20(11):1857-64
pubmed: 25340705
Emerg Infect Dis. 2011 Jan;17(1):7-15
pubmed: 21192848
N S W Public Health Bull. 2004 Sep-Oct;15(9-10):172-7
pubmed: 15657626
J Infect Dis. 2011 Jul 15;204(2):263-7
pubmed: 21673037
Epidemiol Infect. 2008 Apr;136(4):451-60
pubmed: 17565767
Epidemiol Infect. 2012 Nov;140(11):2028-36
pubmed: 22230110
Clin Infect Dis. 2004 Apr 15;38 Suppl 3:S244-52
pubmed: 15095196
Clin Infect Dis. 2008 Nov 1;47(9):1202-8
pubmed: 18808354
Lancet Infect Dis. 2002 Nov;2(11):659-66
pubmed: 12409046
Commun Dis Intell Q Rep. 2015 Jun 30;39(2):E236-64
pubmed: 26234259
Epidemiol Infect. 2017 Jun;145(8):1527-1534
pubmed: 28228183
Foodborne Pathog Dis. 2013 Jul;10(7):639-48
pubmed: 23659355
Clin Infect Dis. 2004 Aug 1;39(3):318-24
pubmed: 15306997
Clin Infect Dis. 2006 May 1;42(9):1298-304
pubmed: 16586390
Clin Infect Dis. 2004 Apr 15;38 Suppl 3:S285-96
pubmed: 15095201
Clin Microbiol Infect. 2014 Aug;20(8):793-8
pubmed: 24382267
PLoS One. 2016 Dec 20;11(12):e0168618
pubmed: 27997598
BMJ Open. 2015 Dec 30;5(12):e010161
pubmed: 26719326
Pediatr Infect Dis J. 2013 Mar;32(3):217-21
pubmed: 23249909
J Food Prot. 1998 Sep;61(9):1229-39
pubmed: 9766083
Emerg Infect Dis. 2012 Mar;18(3):377-84
pubmed: 22377177
Clin Geriatr Med. 2007 Nov;23(4):833-56, vii
pubmed: 17923341
Epidemiol Infect. 2006 Feb;134(1):111-8
pubmed: 16409657
Foodborne Pathog Dis. 2011 Sep;8(9):961-73
pubmed: 21561383
Epidemiol Infect. 2007 Aug;135(6):978-88
pubmed: 17134530
Epidemiol Infect. 2007 Jan;135(1):84-92
pubmed: 16756692
Clin Infect Dis. 2012 Jun;54 Suppl 5:S453-7
pubmed: 22572669
J Am Geriatr Soc. 1991 Sep;39(9):853-7
pubmed: 1885858
Epidemiol Infect. 2004 Aug;132(4):607-17
pubmed: 15310162
BMC Public Health. 2010 Jan 30;10:48
pubmed: 20113516
Foodborne Pathog Dis. 2006 Winter;3(4):432-8
pubmed: 17199525
BMC Public Health. 2006 Dec 19;6:307
pubmed: 17178001
J Am Geriatr Soc. 2009 Mar;57(3):375-94
pubmed: 19278394
J Infect Dis. 2006 Jul 15;194(2):222-30
pubmed: 16779729

Auteurs

Alice E White (AE)

Department of Epidemiology, Colorado School of Public Health, Aurora.

Nadia Ciampa (N)

Public Health Agency of Canada, Centre for Foodborne, Environmental, and Zoonotic Infectious Disease, Guelph, Ontario.

Yingxi Chen (Y)

Australian National University, Canberra, Australian Capital Territory.

Martyn Kirk (M)

Australian National University, Canberra, Australian Capital Territory.

Andrea Nesbitt (A)

Public Health Agency of Canada, Centre for Foodborne, Environmental, and Zoonotic Infectious Disease, Guelph, Ontario.

Beau B Bruce (BB)

Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.

Elaine Scallan Walter (ES)

Department of Epidemiology, Colorado School of Public Health, Aurora.

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Classifications MeSH