Clinical characteristics and outcomes of bacterial and viral gastrointestinal infection by pathogen: a large-scale observational study in United States.

BACKGROUND

The evaluations of clinical characteristics and outcomes by specific gastrointestinal (GI) pathogen are critical. This study aimed to evaluate GI pathogen-specific clinical characteristics and outcomes using a large-scale database.

METHODS

This retrospective cohort study used a database (TriNetX) of multicenter electronic health records to evaluate clinical characteristics and outcomes of GI infection by 14 bacterial and viral pathogen groups. Evaluated clinical outcomes were all-cause 30-day ward admission, critical care admission and mortality.

RESULTS

The number of patients with GI infection by pathogen ranged from Vibrio (N = 373) to norovirus (N = 24,100). For all-cause 30-day mortality, norovirus had the higher mortality rate (1.7%) than other viruses, including 0.4% for rotavirus, 0.9% for adenovirus, 0.5% for astrovirus, and 0.5% for sapovirus. The comparative trends by pathogen were maintained for the all-cause 30-day critical care admission rate and hospitalization rate. The elderly had the highest mortality rate across investigated GI pathogens. For the critical care admission rate by age group, Shiga toxin-producing E. coli (7.2%) and norovirus (5.0%) had relatively high critical care admission rates in children <5 years.

CONCLUSION

Severe clinical outcomes following GI infection were not rare across investigated pathogens with the elderly having the highest mortality rate. A limitation of this study was that it assessed only all-cause outcome events. The study findings may guide future development and allocation of preventive and therapeutic interventions.