Infectious Diseases Unit, Assaf Harofeh Medical Center, Zerifin, Israel.
Eur J Clin Microbiol Infect Dis. 2010 Sep;29(9):1103-9. doi: 10.1007/s10096-010-0968-1. Epub 2010 Jun 10.
Extraintestinal disease occurs in 5-8% of non-typhoid Salmonella enterica (NTS) infections and is more likely to be associated with hospitalization and death. The study examined the epidemiology of extraintestinal NTS infections in Israel and the possible effects of patients' age and sex. NTS isolates passively submitted to the National Salmonella Reference Center during 1996-2006 were the source for the study cohort. Poisson regression models were used to assess incidence trends over the study years and to evaluate the effects of patients' age and sex on the incidence of extraintestinal NTS manifestations. A total of 36,822 stool and 1,415 (3.7%) patient-unique NTS isolates from blood (74.1%), urine (18.3%), and other sources (3.7%) were studied. Serotypes Enteritidis, Virchow, and Typhimurium accounted for 66.3% of the isolates. Analysis showed a highly significant quadratic (U-shaped) relationship between patients' age and the incidence of extraintestinal isolation (p < 0.001), with increasing risk in the two extremes of age. Differences between the incidence of blood and urine sources were significant in patients <10 and >or=60 years old (relative risk [RR] = 5.88, 95% confidence interval [CI] 3.36-10.30, p < 0.001 and RR = 1.66, 95% CI 1.09-2.53, p = 0.017, respectively). Males >or=60 years of age were more likely than females of the same age to have bacteremia (RR = 1.90, 95% CI 1.39-2.61, p > 0.001) and less likely to have urinary NTS isolation (RR = 0.50, 95% CI 0.28-0.89, p = 0.018). Serotype Virchow had the highest incidence in patients <10 years of age, while serotype Enteritidis had the highest incidence in patients >or=60 years old. The study revealed a complex effect of patients' age and sex on the epidemiology of extraintestinal NTS manifestations.
肠道外疾病发生于 5-8%的非伤寒沙门氏菌（NTS）感染，更可能与住院和死亡相关。本研究检查了以色列肠道外 NTS 感染的流行病学，以及患者年龄和性别可能产生的影响。1996-2006 年，国家沙门氏菌参考中心被动提交的 NTS 分离株是本研究队列的来源。泊松回归模型用于评估研究期间的发病趋势，并评估患者年龄和性别对肠道外 NTS 表现发病率的影响。共研究了 36822 份粪便样本和 1415 份（3.7%）来自血液（74.1%）、尿液（18.3%）和其他来源（3.7%）的患者独特 NTS 分离株。肠沙门氏菌血清型肠炎、维尔肖和鼠伤寒分别占分离株的 66.3%。分析显示，患者年龄与肠道外分离发病率之间存在高度显著的二次（U 形）关系（p<0.001），在年龄两端风险增加。在<10 岁和≥60 岁的患者中，血液和尿液来源的发病率差异具有统计学意义（相对风险[RR] = 5.88，95%置信区间[CI] 3.36-10.30，p<0.001；RR = 1.66，95%CI 1.09-2.53，p = 0.017）。≥60 岁的男性比同年龄的女性更有可能发生菌血症（RR = 1.90，95%CI 1.39-2.61，p>0.001），而发生尿 NTS 分离的可能性较小（RR = 0.50，95%CI 0.28-0.89，p = 0.018）。血清型维尔肖在<10 岁的患者中发病率最高，而血清型肠炎在≥60 岁的患者中发病率最高。本研究揭示了患者年龄和性别对肠道外 NTS 表现流行病学的复杂影响。
