Burden of inflammatory enteritis caused by diarrheagenic Escherichia coli in Spain (2016-2022).
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OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.