Invasive multidrug-resistant non-typhoidal Salmonella infections in Africa:: zoonotic or anthroponotic transmission?
Invasive multidrug-resistant non-typhoidal Salmonella infections in Africa:: zoonotic or anthroponotic transmission?
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DOI：
10.1099/jmm.0.46375-0
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发表时间：
2006-05-01
影响因子：
3
通讯作者：
Hart, CA
中科院分区：
文献类型：
--
作者：
Kariuki, S;Revathi, G;Hart, CA
在非洲，耐多药非伤寒沙门氏菌是5岁以下儿童发病率和死亡率高的主要原因之一，仅次于肺炎球菌疾病。作者研究了肯尼亚内罗毕两家医院儿科住院患者中的NTS分离株，并跟踪索引病例到其家中，在那里获得了父母和兄弟姐妹以及密切接触动物的直肠拭子和粪便。从病例中获得的大多数NTS是肠道沙门氏菌血清型鼠伤寒（106/193; 54.9%）和肠道沙门氏菌血清型肠杆菌（64; 33-2%），其中很大一部分（34-2%）对三种或更多种抗生素多重耐药，包括氨苄西林、四环素、复方新诺明和氯霉素。只有23-4%的NTS对所有10种抗生素完全敏感。在32个NITS从接触者（9名成人和23名儿童）在家里的索引病例，21（65.6%）分离株是相似的抗生素敏感性概况和质粒含量，和他们的XbaI和Spel消化的染色体DNA模式是无法区分的相应的索引病例。在180个来自环境来源的样本中，只有3个（1-7%）样本，包括动物、土壤、下水道和食物，含有与相应指数病例相匹配的NTS。在无症状人群中携带NTS的人占127个抽样家庭中27个的6-9%。这一人群的携带者可能代表了一个重要的水库，将发挥重要作用的流行病学社区获得性NTS菌血症的儿童。
In Africa, multidrug-resistant non-typhoidal salmonellae (NTS) are one of the leading causes of morbidity and high mortality in children under 5 years of age, second in importance only to pneumococcal disease. The authors studied NTS isolates from paediatric admissions at two hospitals in Nairobi, Kenya, and followed the index cases to their homes, where rectal swabs and stools from parents and siblings, and from animals in close contact, were obtained. The majority of NTS obtained from cases were Salmonella enterica serotype Typhimurium (106 out of 193; 54.9%) and Salmonella enterica serotype Enteritidis (64; 33-2%), a significant proportion (34-2%) of which were multiply resistant to three or more antibiotics, including ampicillin, tetracycline, cotrimoxazole and chloramphenicol. Only 23-4% of NTS were fully susceptible to all 10 antibiotics tested. Of the 32 NITS obtained from contacts (nine adults and 23 children) at the homes of index cases, 21 (65.6%) isolates were similar by antibiotic-susceptibility profiles and plasmid content, and their Xbal- and Spel-digested chromosomal DNA patterns were indistinguishable from those of the corresponding index cases. Only three out of 180 (1-7%) samples from environmental sources, including animals, soil, sewers and food, contained NTS matching those from corresponding index cases. The carriage of NTS in an asymptomatic population was represented by 6-9% of human contacts from 27 out of 127 homes sampled. This population of carriers may represent an important reservoir of NTS that would play a significant role in the epidemiology of community-acquired NTS bacteraemia in children.