Open Forum Infect Dis. 2026 Jul 25;13(8):ofag451. doi: 10.1093/ofid/ofag451. eCollection 2026 Aug.
ABSTRACT
BACKGROUND: Campylobacter and Salmonella are leading causes of bacterial gastroenteritis worldwide, yet their comparative impact on acute kidney injury (AKI) remains unexplored.
METHODS: We conducted a retrospective cohort study of adults (≥18 years) hospitalized with community-acquired bacterial gastroenteritis at a tertiary center in South Korea (2018-2025). The primary outcome was AKI incidence. Multivariable logistic regression assessed associations between pathogen type (Campylobacter, Salmonella, or Others, including Escherichia coli or Clostridium difficile) and AKI risk (reference: Campylobacter). Secondary outcomes included postdischarge kidney outcomes (acute kidney disease [AKD], incident chronic kidney disease [CKD], and CKD progression).
RESULTS: Among 232 patients (Campylobacter n = 139, Salmonella n = 55, and Others n = 38), AKI incidence differed significantly across groups (26.6%, 70.9%, and 31.6%, respectively; P < .001), with 42% of Salmonella patients developing AKI stages 2 and 3. Salmonella enteritis was independently associated with higher AKI risk than Campylobacter (odds ratio 3.19, 95% confidence interval [CI] 1.23-8.30). Salmonella patients had 46% longer hospital stays (median 8 vs 5 days). In-hospital AKI was associated with postdischarge composite kidney outcome (hazard ratio 3.17, 95% CI 1.02-9.83), particularly during the AKD window (7-90 days postdischarge). Notably, 17% of patients who recovered from AKI before discharge subsequently developed AKD or CKD.
CONCLUSIONS: In this retrospective study, hospitalized patients with Salmonella enteritis had a higher risk of AKI than those with Campylobacter; furthermore, those with in-hospital AKI from any cause were more likely to have adverse short-to-intermediate-term postdischarge kidney abnormalities. These findings support pathogen-specific risk stratification and the need for postdischarge monitoring of patients who develop in-hospital AKI.
PMID:42542862 | PMC:PMC13428291 | DOI:10.1093/ofid/ofag451