The decline of typhoid and the rise of non-typhoid salmonellae and fungal infections in a changing HIV landscape: bloodstream infection trends over 15 years in southern Vietnam
The decline of typhoid and the rise of non-typhoid salmonellae and fungal infections in a changing HIV landscape: bloodstream infection trends over 15 years in southern Vietnam
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DOI：
10.1016/j.trstmh.2011.10.004
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发表时间：
2012-01-01
影响因子：
2.2
通讯作者：
Baker, Stephen
中科院分区：
文献类型：
--
作者：
Tran Vu Thieu Nga;Parry, Christopher M.;Baker, Stephen
血流感染的病因谱在工业化国家和发展中国家之间是可变的，甚至在一个确定的地点内也是可变的。我们调查了1994-2008年越南胡志明市传染病医院血液感染的趋势。在进行的66111次血培养中，在7645次发作中分离出临床相关病原体（阳性率; 116/1000次培养）。伤寒沙门氏菌在2002年以前是主要的病原体，然而，伤寒沙门氏菌的比例逐年下降。观察到伤寒（OR 0.6993，95%CI [0.6885，0.7103]，p < 0.0001）。相反，非伤寒沙门氏菌（NTS），新型隐球菌和马尔尼菲青霉菌的比例显着增加，同时增加艾滋病毒的流行。这些数据记录了越南南部血流感染病因学的实质性纵向变化。我们认为这种变化与经济繁荣和艾滋病流行有关，这种模式标志着东南亚侵袭性沙门氏菌病流行病学的重大变化。(C)2011年皇家热带医学和卫生学会。由爱思唯尔有限公司出版。保留所有权利。
The etiological spectrum of bloodstream infections is variable between industrialized and developing countries and even within a defined location over time. We investigated trends in bloodstream infections at an infectious disease hospital in Ho Chi Minh City, Vietnam, from 1994-2008. Amongst 66111 blood cultures performed, a clinically relevant pathogen was isolated in 7645 episodes (positivity rate; 116/1000 cultures). Salmonella Typhi was the predominant pathogen until 2002; however, a considerable annual decline in the proportion of S. Typhi was observed (OR 0.6993, 95% CI [0.6885, 0.7103], p < 0.0001). Conversely, there was a significant increase in the proportions of non-typhoidal Salmonella (NTS), Cryptococcus neoformans and Penicillium marneffei, concurrent with increasing HIV prevalence. These data document a substantial longitudinal shift in bloodstream infection etiology in southern Vietnam. We propose such changes are related to increasing economic prosperity and HIV prevalence, and this pattern marks a substantial change in the epidemiology of invasive salmonellosis in Southeast Asia. (C) 2011 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.