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

<jats:sec><jats:title>Objective</jats:title><jats:p>The aim of this study was to investigate the relationship between non-typhoidal<jats:italic>Salmonella</jats:italic>(NTS) infection and the risk of Kawasaki disease (KD) by using a nationwide population-based data set in Taiwan.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>In this retrospective cohort study, we enrolled 69,116 patients under 18 years of age, with NTS from January 1<jats:sup>st</jats:sup>, 2000, to December 31<jats:sup>st</jats:sup>, 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 31<jats:sup>st</jats:sup>, 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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>After 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 &lt; 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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>NTS is associated with an increased risk of KD in Taiwanese children.</jats:p></jats:sec>