Ethelberg Steen, Müller Luise, Mølbak Kåre, Nielsen Eva Møller
Statens Serum Institut, Epidemiologisk Afdeling, København S, Denmark.
Ugeskr Laeger. 2010 May 10;172(19):1451-5.
Information about whether Salmonella and Campylobacter infections are acquired during foreign travel has previously been incomplete. We collected such information systematically for 2008.
Information from all laboratory-confirmed cases of Salmonella and Campylobacter-cases from three laboratory catchment areas were prospectively collected by telephone interviews.
Of the overall 3,675 cases of Salmonella infection in 2008, information about recent travel was obtained in 3,152 (86%). Among these, 61% of S. Enteritidis, 6% of S. Typhimurium, and 34% of individuals infected with other serotypes were acquired abroad. Among the isolates that were tested for antimicrobial drug sensitivity, 21% of the isolates acquired during foreign travel were resistant and 9% were multidrug-resistant compared with 7% and 2%, respectively, of the indigenous strains. Nearly a quarter of the 3,455 registered Campylobacter cases were included in the survey, and information about recent travel was obtained from 82%. Among these, 33% were acquired abroad.
The proportion of Salmonella infections acquired abroad varies by serotype. S. Enteritidis used to be the most frequent serotype, predominantly acquired from contaminated Danish egg, but S. Enteritidis is today primarily an imported infection. By contrast, S. Typhimurium is predominately acquired in Denmark. The latter observation should be interpreted on the background of the unprecedented large outbreaks of S. Typhimurium in 2008. There was a clear association between a history of foreign travel and the risk of acquiring an infection with a drug-resistant strain.
此前关于沙门氏菌和弯曲杆菌感染是否在国外旅行期间感染的信息并不完整。我们系统收集了2008年的此类信息。
通过电话访谈前瞻性收集来自三个实验室集水区的所有实验室确诊的沙门氏菌和弯曲杆菌病例的信息。
在2008年总计3675例沙门氏菌感染病例中,获取了3152例(86%)近期旅行的信息。其中,肠炎沙门氏菌感染病例的61%、鼠伤寒沙门氏菌感染病例的6%以及感染其他血清型的个体中的34%是在国外感染的。在接受抗菌药物敏感性检测的分离株中,国外旅行期间感染的分离株有21%耐药,9%多重耐药,相比之下,本土菌株的这一比例分别为7%和2%。在3455例登记的弯曲杆菌病例中,近四分之一纳入了调查,82%的病例获取了近期旅行信息。其中,33%是在国外感染的。
国外感染的沙门氏菌感染比例因血清型而异。肠炎沙门氏菌曾经是最常见的血清型,主要从受污染丹麦鸡蛋中感染,但如今肠炎沙门氏菌主要是输入性感染。相比之下,鼠伤寒沙门氏菌主要在丹麦感染。后一观察结果应结合2008年鼠伤寒沙门氏菌前所未有的大规模暴发这一背景来解读。国外旅行史与感染耐药菌株的风险之间存在明显关联。