Burden of inflammatory enteritis caused by diarrheagenic Escherichia coli in Spain (2016-2022)

Diarrheal diseases caused by diarrheagenic Escherichia coli (DEC) are a significant public health challenge, particularly among vulnerable populations such as children and the elderly. This study aimed to analyze the burden of DEC-related inflammatory enteritis in Spain, focusing on hospitalization rates, mortality, and associated risk factors.

Using data from a national registry, we conducted a nationwide, retrospective analysis including hospitalized patients with DEC from 2016 to 2022. We used descriptive statistics and multivariable logistic regression to assess predictors of mortality.

We identified 265,754 hospitalizations related to DEC. Individuals aged ≥80 years exhibited the highest rates of hospitalization (516 per 100,000). Mortality rates increased with age. The elderly show the highest mortality rate (53.8 % of deaths). Women had higher mortality rates than men, especially in older age groups. Multivariable logistic regression identified age ≥ 80 years, comorbidities such as malignancy (odds ratio [OR] = 2.23, 95 % CI = 2.15, 2.3) and sepsis (OR = 3.6, 95 % CI = 3.47, 3.74), and coinfections with Staphylococcus aureus (OR = 3.46, 95 % CI = 2.1, 5.69) and COVID-19 (OR = 2.35, 95 % CI = 2.21, 2.49) as significant predictors of mortality. Regional disparities in hospitalization and mortality rates were also observed.

These findings underscore the growing burden of DEC-related diarrhea in Spain, particularly among aging populations, and highlight the need for targeted public health interventions, improved diagnostic protocols, and integrated care for patients with comorbidities.