Time-dependent risk of atopic dermatitis following nontyphoidal Salmonella infection

Author:

Chang Renin123ORCID,Chen Hui-Yuan4,Hung Yao-Min5,Huang Jing-Yang46,Wei James Cheng-Chung4789

Affiliation:

1. Department of Medical Education and Research , Kaohsiung Veterans General Hospital, Kaohsiung 81362 , Taiwan

2. Department of Emergency Medicine , Kaohsiung Veterans General Hospital, Kaohsiung 40201 , Taiwan

3. School of Medicine , Chung Shan Medical University, Taichung 95050 , Taiwan

4. Institute of Medicine, Chung Shan Medical University , Taichung 40201 , Taiwan

5. Division of Nephrology , Department of Internal Medicine, Taipei Veterans General Hospital Taitung Branch, 40201 , Taiwan

6. Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan

7. Division of Allergy , Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung 40432 , Taiwan

8. Department of Nursing, Chung Shan Medical University , Taichung 40721 , Taiwan

9. Graduate Institute of Integrated Medicine , China Medical University, Taichung , Taiwan

Abstract

Abstract Background The pathogenesis of atopic dermatitis (AD) remains unclear. Nontyphoidal Salmonella (NTS) infection might trigger immune-mediated reactions. We aimed to examine NTS and the risk of subsequent AD. Methods From 2002 to 2015, eligible patients (aged 0–100 years) with NTS were identified. NTS and non-NTS groups were matched at a 1:10 ratio on age and sex. We utilized conditional multivariable Cox proportional hazard models to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for AD development. Subgroup analyses were conducted based on age, sex, and severity of NTS infection. We utilized landmark analysis to explore the time-dependent hazard of AD following NTS. Results In the NTS group (N = 6624), 403 developed AD. After full adjustment of demographics and comorbidities, the NTS group had a higher risk of AD than the reference group (aHR = 1.217, 95% CI = 1.096–1.352). Age-stratified analysis revealed that NTS group exhibited an elevated risk compared to the reference group, particularly among those aged 13–30 years (aHR = 1.25, 95% CI = 1.017–1.559), individuals aged 31–50 years (aHR = 1.388, 95% CI = 1.112–1.733), those aged 51–70 years (aHR = 1.301, 95% CI = 1.008–1.679), and individuals aged 71 years and over (aHR = 1.791, 95% CI = 1.260–2.545). Severe NTS was associated with a higher risk of AD than the reference group (aHR = 2.411, 95% CI = 1.577–3.685). Landmark analysis showed generally consistent findings. Conclusions Minimizing exposure to NTS infection may represent a prospective strategy for averting the onset and progression of atopic dermatitis.

Funder

Kaohsiung Veterans General Hospital

Chung Shan Medical University Hospital

Publisher

Oxford University Press (OUP)

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