Non-Typhoidal Salmonella and the Risk of Kawasaki Disease: A Nationwide Population-Based Cohort Study

Abstract

ObjectiveThe aim of this study was to investigate the relationship between non-typhoidal Salmonella (NTS) infection and the risk of Kawasaki disease (KD) by using a nationwide population-based data set in Taiwan.MethodsIn this retrospective cohort study, we enrolled 69,116 patients under 18 years of age, with NTS from January 1st, 2000, to December 31st, 2013, using the population-based National Health Insurance Research Database of Taiwan. A comparison group without NTS was matched (at a 1:4 ratio) by propensity score. The two cohorts were followed from the initial diagnosis of NTS until the date of KD development or December 31st, 2013. Cox proportional hazard regression analysis was conducted to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after adjusting for covariates. Also, we conducted sensitivity analyses to examine our findings.ResultsAfter adjusting for covariates, the risk of KD for the children with NTS was significantly higher than that of the comparison group (hazard ratio = 1.31; 95% confidence interval = 1.03-1.66; p < 0.01). Stratified analysis showed that the associated risk of the investigated outcome was significant in children aged ≤2 years (aHR= 1.31, 95% C.I. 1.02-1.69), in female patients (aHR= 1.46, 95% C.I. 1.03-2.08), and in those without allergic diseases.ConclusionsNTS is associated with an increased risk of KD in Taiwanese children.

Retrospective analysis of clinical characteristics and related influencing factors of Kawasaki disease

“…[ 8 – 10 ] In this study, 68.34% of children are under 3 years old, which is consistent with the research results of most scholars. [ 2 , 11 ] It can be seen from the comparison of age distribution of KD and IKD that there is no significant statistical difference between the 2, indicating that the age distribution of IKD and KD is consistent. Relevant studies showed that KD has a special male susceptibility.…”

“…Kawasaki disease (KD) is an acute febrile and eruptive disease with systemic small and medium-sized arteritis as the main pathological change. [ 1 , 2 ] At present, the cause of the disease is unknown, and it is mostly detected in Asian children under 5 years old. [ 1 , 3 ] Coronary artery lesions (CAL) are common complications of KD, which can lead to ischemic heart disease, myocardial infarction, sudden death and other serious consequences.…”