Prevalence and Correlates of NTS Bacteremia, Diarrhea and Carriage in Kenya

总结（参见说明）; 由于非伤寒沙门氏菌菌株（NTS）引起的侵袭性感染似乎正在成为一种新的流行病。 是撒哈拉以南非洲地区血液感染的常见原因。在非洲，多达40%的菌血症儿童血培养分离株和20%的重症肺炎儿童血培养分离株是由NTS引起的。虽然由于侵入性NTS引起的高负担和疾病严重程度的确切原因尚不完全清楚，但似乎NTS的传播可能主要是由于非洲的人与人之间的接触。这与世界其他地区的主要食源性传播途径形成鲜明对比。宿主特征的差异（艾滋病毒感染率高、营养不良）和不同的社会经济条件（难以获得清洁水和卫生设施、更多的农村环境）可能会增加人与人之间的传播风险。此外，病原体特异性差异也可能在增加非洲NTS分离株的多样性和毒力方面发挥重要作用。我们建议通过研究宿主易感性的差异、菌株多样性和毒力的变化以及无症状携带在促进NTS人-人传播中的作用，更清楚地定义非洲NTS疾病的流行病学。

SUMMARY (See instructions); Invasive infections due to non-typhoidal salmonella strains (NTS) appear to be emerging as a common cause of bloodstream infection in sub-Saharan Africa. As many as 40% of blood culture isolates from bacteremic children and 20% of blood culture isolates in children with severe pneumonia are due to NTS in Africa. While the exact reasons for the high burden and severity of disease due to invasive NTS are incompletely understood, it appears that transmission of NTS may be largely due to human-human contact in Africa. This is in contrast to the largely foodborne route of transmission seen in other areas of the world Differences in host characteristics (high rates of HIV, malnutrition) and differing socio-economic conditions (poor access to clean water and sanitation, more rural environment) may contribute to human-human risk of transmission. In addition, it is possible that pathogen specific differences may also be important in increasing the diversity and virulence of NTS isolates in Africa. We propose to more clearly define the epidemiology of NTS disease in Africa by examining differences in host susceptibility, changes in strain diversity and virulence, and the role of asymptomafic carriage in promofing human-human transmission of NTS.