Appendectomy a risk factor for nontyphoidal salmonella infection in children

Children who underwent appendectomy are at increased risk of subsequent nontyphoidal salmonella (NTS) infection, as shown in a study.

Researchers used data from Taiwan’s National Health Insurance Research Database. They established a cohort of 18,654 children (mean age 10.04 years, 63.7 percent male) who underwent appendectomy and were matched to 74,616 children (mean age 9.73 years, 63.7 percent male) who had not undergone appendectomy based on age, sex, and index date.

The primary outcome of NSA infection was defined as three outpatient or one inpatient diagnosis after the index date.

Cox proportional hazards models showed that compared with controls, children who underwent appendectomy had a 58-percent higher risk of NTS infection (adjusted hazard ratio [aHR], 1.58, 95 percent confidence interval [CI], 1.17–2.13). The risk increase was especially pronounced in children younger than 5 years (aHR, 2, 95 percent CI, 1.35–2.97).

The risk of NTS infection associated with appendectomy was elevated but not statistically significant during 1–4 years of follow-up (aHR, 1.51, 95 percent CI, 0.98–2.32) and 5 or more years of follow-up (aHR, 1.78, 95 percent CI, 0.89–3.54).

These findings point to the need for surveillance and preventive strategies in children following appendectomy, although additional studies are warranted to develop and evaluate specific interventions.