Cheng Lay Har, Crim Stacy M, Cole Conrad R, Shane Andi L, Henao Olga L, Mahon Barbara E
Pediatric Gastroenterology, Hepatology and Nutrition, Emory University School of Medicine, and
Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
J Pediatric Infect Dis Soc. 2013 Sep;2(3):232-9. doi: 10.1093/jpids/pit020. Epub 2013 Apr 11.
Infants have increased risk for salmonellosis; but epidemiologic information is limited.
We reviewed Foodborne Diseases Active Surveillance Network reports of laboratory-confirmed non-Typhi Salmonella infections in infants from 1996-2008. We calculated incidence, estimated relative risks, and assessed trends over the duration of the study period, using the first 3 years as reference.
Average annual incidence of salmonellosis per 100 000 infants was 177.8 (95% confidence interval [CI], 152.7-202.8) in blacks, 129.7 (95% CI, 94.8-164.7) in Asians, and 81.1 (95% CI, 70.2-92.0) in whites. Our analysis of ethnicity independent of race showed salmonellosis incidence of 86.7 (95% CI, 74.6-98.9) in Hispanics and 69.4 (95% CI, 54.8-84.1) in non-Hispanics. Salmonellosis was invasive more often in blacks (9.4%) and Asians (6.4%) than whites (3.6%, P <.001 and P = .01, respectively). Asian infants with salmonellosis were older (median, 31 weeks [range, 0-52]) than black (24 weeks [range, 0-52], P < .001) or white infants (23 weeks [range, 0-52], P < .001). Incidence of all salmonellosis remained stable for whites from 1996-1998 through 2008, but blacks had a sustained decrease, with relative risk of 0.48 (95% CI, .37-.63) in 2008 compared with 1996-1998. However, 2008 incidence remained highest among blacks (141.0 of 100 000 vs 113.5 of 100 000 among whites and 109.9 of 100 000 among Asians).
Black infants had a greater risk of salmonellosis and invasive disease than other racial groups, and despite the greatest decrease in incidence over the study period, they continued to have the highest incidence of salmonellosis. The decrease in salmonellosis in black infants suggests that future improvements may be possible for other population subgroups.
婴儿感染沙门氏菌病的风险增加；但流行病学信息有限。
我们回顾了1996 - 2008年食源性疾病主动监测网络关于实验室确诊的婴儿非伤寒沙门氏菌感染的报告。我们计算了发病率、估计相对风险，并评估了研究期间的趋势，以最初3年作为参照。
每10万名婴儿中沙门氏菌病的年均发病率在黑人中为177.8（95%置信区间[CI]，152.7 - 202.8），在亚洲人中为129.7（95%CI，94.8 - 164.7），在白人中为81.1（95%CI，70.2 - 92.0）。我们对不考虑种族的族裔分析显示，西班牙裔中沙门氏菌病发病率为86.7（95%CI，74.6 - 98.9），非西班牙裔中为69.4（95%CI，54.8 - 84.1）。沙门氏菌病侵袭性感染在黑人（9.4%）和亚洲人（6.4%）中比在白人中更常见（分别为3.6%，P <.001和P =.01）。患沙门氏菌病的亚洲婴儿年龄比黑人婴儿（中位数24周[范围，0 - 52周]，P <.001）和白人婴儿（中位数23周[范围，0 - 52周]，P <.001）更大（中位数31周[范围，0 - 52周]）。从1996 - 1998年到2008年，白人中所有沙门氏菌病的发病率保持稳定，但黑人发病率持续下降，2008年与1996 - 1998年相比相对风险为0.48（95%CI，0.37 - 0.63）。然而，2008年黑人中的发病率仍然最高（每10万人中141.0例，而白人中为每10万人中113.5例，亚洲人中为每10万人中109.9例）。
黑人婴儿比其他种族群体患沙门氏菌病和侵袭性疾病的风险更高，尽管在研究期间发病率下降幅度最大，但他们的沙门氏菌病发病率仍然最高。黑人婴儿沙门氏菌病发病率的下降表明其他人群亚组未来可能会有改善。
