Invasive Salmonella Infections in Areas of High and Low Malaria Transmission Intensity in Tanzania
Invasive Salmonella Infections in Areas of High and Low Malaria Transmission Intensity in Tanzania
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DOI：
10.1093/cid/cit798
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发表时间：
2014-03-01
影响因子：
11.8
通讯作者：
Crump, John A.
中科院分区：
文献类型：
--
作者：
Biggs, Holly M.;Lester, Rebecca;Crump, John A.
背景伤寒沙门氏菌和侵袭性非伤寒沙门氏菌（NTS）的流行病学不同，这些病原体在撒哈拉以南非洲儿童中的流行率可能与疟疾传播强度有关。我们比较了在坦桑尼亚疟疾高流行区和低流行区招募的2个月至13岁发热儿科住院患者的菌血症患病率。疟疾高传播点Teule医院的登记时间为2006年6月至2007年5月，疟疾低传播点基利曼哈罗基督教医疗中心的登记时间为2007年9月至2008年8月。进行自动血培养、吉姆萨染色血膜疟疾显微镜检查和人类免疫缺陷病毒检测。Teule招收了3639名儿童，而KCMC招收了467名儿童。在Teule的3639名儿童中有2195名（60.3%）和KCMC的460名儿童中有11名（2.4%）检测到疟疾涂片阳性（P <0.001）。Teule的3639名儿童中有336名（9.2%）存在菌血症，KCMC的463名儿童中有20名（4.3%）存在菌血症（P <0.001）。在Teule的3639名儿童中有162名（4.5%）分离出NTS，在KCMC的463名儿童中有1名（0.2%）分离出NTS（P <0.001）。从Teule的11名（0.3%）儿童和KCMC的6名（1.3%）儿童中分离出伤寒沙门氏菌（P = 0.008）。排除NTS后，Teule和KCMC的菌血症患病率分别为5.0%和4.1%（P = 0.391）。疟疾传播是激烈的，侵入性NTS是常见的，伤寒沙门氏菌是罕见的，而相反的是在低疟疾传播网站观察。这些病原体、环境和宿主之间的关系是进一步研究的一个引人注目的领域。
Background. The epidemiology of Salmonella Typhi and invasive nontyphoidal Salmonella (NTS) differs, and prevalence of these pathogens among children in sub-Saharan Africa may vary in relation to malaria transmission intensity.Methods. We compared the prevalence of bacteremia among febrile pediatric inpatients aged 2 months to 13 years recruited at sites of high and low malaria endemicity in Tanzania. Enrollment at Teule Hospital, the high malaria transmission site, was from June 2006 through May 2007, and at Kilimanjaro Christian Medical Centre (KCMC), the low malaria transmission site, from September 2007 through August 2008. Automated blood culture, malaria microscopy with Giemsa-stained blood films, and human immunodeficiency virus testing were performed.Results. At Teule, 3639 children were enrolled compared to 467 at KCMC. Smear-positive malaria was detected in 2195 of 3639 (60.3%) children at Teule and 11 of 460 (2.4%) at KCMC (P < .001). Bacteremia was present in 336 of 3639 (9.2%) children at Teule and 20 of 463 (4.3%) at KCMC(P < .001). NTS was isolated in 162 of 3639 (4.5%) children at Teule and 1 of 463 (0.2%) at KCMC (P < .001). Salmonella Typhi was isolated from 11 (0.3%) children at Teule and 6 (1.3%) at KCMC (P = .008). With NTS excluded, the prevalence of bacteremia at Teule was 5.0% and at KCMC 4.1% (P = .391).Conclusions. Where malaria transmission was intense, invasive NTS was common and Salmonella Typhi was uncommon, whereas the inverse was observed at a low malaria transmission site. The relationship between these pathogens, the environment, and the host is a compelling area for further research.