Salmonella enterica bacteraemia: a multi-national population-based cohort study

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Abstract

Background

Salmonella enterica is an important emerging cause of invasive infections worldwide. However, population-based data are limited. The objective of this study was to define the occurrence of S. enterica bacteremia in a large international population and to evaluate temporal and regional differences.

Methods

We conducted population-based laboratory surveillance for all salmonella bacteremias in six regions (annual population at risk 7.7 million residents) in Finland, Australia, Denmark, and Canada during 2000-2007.

Results

A total of 622 cases were identified for an annual incidence of 1.02 per 100,000 population. The incidence of typhoidal (serotypes Typhi and Paratyphi) and non-typhoidal (other serotypes) disease was 0.21 and 0.81 per 100,000/year. There was major regional and moderate seasonal and year to year variability with an increased incidence observed in the latter years of the study related principally to increasing rates of non-typhoidal salmonella bacteremias. Advancing age and male gender were significant risk factors for acquiring non-typhoidal salmonella bacteremia. In contrast, typhoidal salmonella bacteremia showed a decreasing incidence with advancing age and no gender-related excess risk.

Conclusions

Salmonella enterica is an important emerging pathogen and regional determinants of risk merits further investigation.

Related collections

Most cited references 33

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Typhoid fever in children aged less than 5 years.

J. B. Singh, A Naficy, R. Kumar … (1999)

Calculation of the incidence of typhoid fever during preschool years is important to define the optimum age of immunisation and the choice of vaccines for public-health programmes in developing countries. Hospital-based studies have suggested that children younger than 5 years do not need vaccination against typhoid fever, but this view needs to be re-examined in community-based longitudinal studies. We undertook a prospective follow-up study of residents of a low-income urban area of Delhi, India, with active surveillance for case detection. A baseline census was undertaken in 1995. Between Nov 1, 1995, and Oct 31, 1996, we visited 8172 residents of 1820 households in Kalkaji, Delhi, twice weekly to detect febrile cases. Blood samples were obtained from febrile patients, and those who tested positive for Salmonella typhi were treated with ciprofloxacin. 63 culture-positive typhoid fever cases were detected. Of these, 28 (44%) were in children aged under 5 years. The incidence rate of typhoid per 1000 person-years was 27.3 at age under 5 years, 11.7 at 5-19 years, and 1.1 between 19 and 40 years. The difference in the incidence of typhoid fever between those under 5 years and those aged 5-19 years (15.6 per 1000 person-years [95% CI 4.7-26.5]), and those aged 19-40 years (26.2 [16.0-36.3]) was significant (p<0.001 for both). The difference between the incidence of typhoid at 5-19 years and the incidence at 19-40 years was also significant (10.6 [6.3-14.8], p<0.001). Morbidity in those under 5 and in older people was similar in terms of duration of fever, signs and symptoms, and need for hospital admission. Our findings challenge the common view that typhoid fever is a disorder of school-age children and of adults. Typhoid is a common and significant cause of morbidity between 1 and 5 years of age. The optimum age of typhoid immunisation and the choice of vaccines needs to be reassessed.

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Staphylococcus aureus bloodstream infections: risk factors, outcomes, and the influence of methicillin resistance in Calgary, Canada, 2000-2006.

Daniel B Gregson, Terry Ross, Kevin B Laupland (2008)

Reports have suggested that the epidemiological profile of invasive Staphylococcus aureus infections is changing. We sought to describe the epidemiological profile of S. aureus bacteremia and to assess whether the incidence and severity of and the antimicrobial resistance rates associated with this bacteremia are increasing. Population-based surveillance for S. aureus bacteremias was conducted in the Calgary Health Region (population, 1.2 million) during 2000-2006. The annual incidence of S. aureus bacteremia was 19.7 cases/100,000 population. Although rates of health care-associated and nosocomial methicillin-susceptible S. aureus (MSSA) bacteremia were similar throughout the study, rates of community-acquired MSSA bacteremia gradually decreased, and rates of methicillin-resistant S. aureus (MRSA) bacteremia dramatically increased. The clonal type predominantly isolated was CMRSA-2 (i.e., Canadian [C] MRSA-2), but CMRSA-10 (USA300) strains have been increasingly isolated, especially from community-onset infections, since 2004. Dialysis dependence, organ transplantation, HIV infection, cancer, and diabetes were the most important risk factors and were comparable for MSSA and MRSA bacteremias. The overall case-fatality rate was higher among individuals with MRSA (39%) than among those with MSSA (24%; P< .0001). The annual overall population mortality rate associated with S. aureus bacteremia did not significantly change during the study. Although the overall influence of S. aureus bacteremia has not significantly changed, MRSA has emerged as an important etiology in our region.

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International Salmonella Typhimurium DT104 Infections, 1992–2001

Morten Helms, Steen Ethelberg, Kåre Mølbak (2005)

The incidence of multidrug-resistant (MDR) Salmonella Typhimurium infections in humans, and in particular MDR definitive phage type 104 (DT104), has increased substantially in many countries in the last 2 decades, often associated with increased illness. To examine the magnitude of this problem, a survey was conducted among countries with available antimicrobial resistance or phage typing surveillance data. A total of 29, primarily industrialized, countries participated in the survey, which covered the years 1992–2001. Overall, the incidence of MDR S. Typhimurium and DT104 increased continuously during this period, although the problem affected primarily Europe and North America. The increase appeared to have peaked in the United Kingdom but not in other countries. Also, the incidence of quinolone-resistant S. Typhimurium was increasing. This survey implies that MDR S. Typhimurium constitutes an increasing public health problem in large parts of the world and emphasizes the importance of surveillance and control programs.

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Author and article information

Journal

Journal ID (nlm-ta): BMC Infect Dis

Title: BMC Infectious Diseases

Publisher: BioMed Central

ISSN (Electronic): 1471-2334

Publication date Collection: 2010

Publication date (Electronic): 14 April 2010

Volume: 10

Page: 95

Affiliations

[1 ]Departments of Medicine and Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta, Canada

[2 ]Department of Clinical Microbiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

[3 ]Infectious Diseases Unit and Microbiology Department, The Canberra Hospital and School of Clinical Medicine, Australian National University, Woden, Australian Capital Territory, Australia

[4 ]Department of Infectious Disease Epidemiology, Hospital Infection Program, National Public Health Institute, Helsinki, Finland

[5 ]Department of Microbiology-Infectious Diseases, Université de Sherbrooke, Sherbrooke, Québec, Canada

[6 ]Microbiology Laboratory, Vancouver Island Health Authority, Royal Jubilee Hospital, Victoria, British Columbia, Canada

Article

Publisher ID: 1471-2334-10-95

DOI: 10.1186/1471-2334-10-95

PMC ID: 2861061

PubMed ID: 20398281

SO-VID: be78e268-7a72-46ac-9322-44fb9674d346

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 11 January 2010

Date accepted : 14 April 2010

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Salmonella enterica bacteraemia: a multi-national population-based cohort study

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Coronaviruses, COVID-19 and SARS-CoV-2

Most cited references 33

Typhoid fever in children aged less than 5 years.

Staphylococcus aureus bloodstream infections: risk factors, outcomes, and the influence of methicillin resistance in Calgary, Canada, 2000-2006.

International Salmonella Typhimurium DT104 Infections, 1992–2001

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