Shaw Kristi S, Cruz-Cano Raul, Jiang Chengsheng, Malayil Leena, Blythe David, Ryan Patricia, Sapkota Amy R
Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA.
Environ Res. 2016 Oct;150:166-172. doi: 10.1016/j.envres.2016.05.049. Epub 2016 Jun 9.
Nontyphoidal Salmonella spp. are a leading cause of foodborne illness. Risk factors for salmonellosis include the consumption of contaminated chicken, eggs, pork and beef. Agricultural, environmental and socioeconomic factors also have been associated with rates of Salmonella infection. However, to our knowledge, these factors have not been modeled together at the community-level to improve our understanding of whether rates of salmonellosis are variable across communities defined by differing factors. To address this knowledge gap, we obtained data on culture-confirmed Salmonella Typhimurium, S. Enteritidis, S. Newport and S. Javiana cases (2004-2010; n=14,297) from the Foodborne Diseases Active Surveillance Network (FoodNet), and socioeconomic, environmental and agricultural data from the 2010 Census of Population and Housing, the 2011 American Community Survey, and the 2007 U.S. Census of Agriculture. We linked data by zip code and derived incidence rate ratios using negative binomial regressions. Multiple community-level factors were associated with salmonellosis rates; however, our findings varied by state. For example, in Georgia (Incidence Rate Ratio (IRR)=1.01; 95% Confidence Interval (CI)=1.005-1.015) Maryland (IRR=1.01; 95% CI=1.003-1.015) and Tennessee (IRR=1.01; 95% CI=1.002-1.012), zip codes characterized by greater rurality had higher rates of S. Newport infections. The presence of broiler chicken operations, dairy operations and cattle operations in a zip code also was associated with significantly higher rates of infection with at least one serotype in states that are leading producers of these animal products. For instance, in Georgia and Tennessee, rates of S. Enteritidis infection were 48% (IRR=1.48; 95% CI=1.12-1.95) and 46% (IRR=1.46; 95% CI=1.17-1.81) higher in zip codes with broiler chicken operations compared to those without these operations. In Maryland, New Mexico and Tennessee, higher poverty levels in zip codes were associated with higher rates of infection with one or more Salmonella serotypes. In Georgia and Tennessee, zip codes with higher percentages of the population composed of African Americans had significantly higher rates of infection with one or more Salmonella serotypes. In summary, our findings show that community-level agricultural, environmental and socioeconomic factors may be important with regard to rates of infection with Salmonella Typhimurium, Enteritidis, Newport and Javiana.
非伤寒沙门氏菌属是食源性疾病的主要病因。沙门氏菌病的风险因素包括食用受污染的鸡肉、鸡蛋、猪肉和牛肉。农业、环境和社会经济因素也与沙门氏菌感染率有关。然而，据我们所知，这些因素尚未在社区层面进行综合建模，以增进我们对不同因素定义的社区中沙门氏菌病发病率是否存在差异的理解。为填补这一知识空白，我们从食源性疾病主动监测网络（FoodNet）获取了经培养确诊的鼠伤寒沙门氏菌、肠炎沙门氏菌、纽波特沙门氏菌和爪哇那沙门氏菌病例数据（2004 - 2010年；n = 14,297），并从2010年人口与住房普查、2011年美国社区调查以及2007年美国农业普查中获取了社会经济、环境和农业数据。我们按邮政编码链接数据，并使用负二项回归得出发病率比。多个社区层面的因素与沙门氏菌病发病率相关；然而，我们的研究结果因州而异。例如，在佐治亚州（发病率比（IRR）= 1.01；95%置信区间（CI）= 1.005 - 1.015）、马里兰州（IRR = 1.01；95% CI = 1.003 - 1.015）和田纳西州（IRR = 1.01；95% CI = 1.002 - 1.012），农村程度更高的邮政编码地区纽波特沙门氏菌感染率更高。在这些动物产品主要生产州，邮政编码地区存在肉鸡养殖场、奶牛养殖场和肉牛养殖场也与至少一种血清型的感染率显著升高有关。例如，在佐治亚州和田纳西州，有肉鸡养殖场的邮政编码地区肠炎沙门氏菌感染率分别比没有这些养殖场的地区高48%（IRR = 1.48；95% CI = 1.12 - 1.95）和46%（IRR = 1.46；95% CI = 1.17 - 1.81）。在马里兰州、新墨西哥州和田纳西州，邮政编码地区贫困水平较高与一种或多种沙门氏菌血清型的感染率较高有关。在佐治亚州和田纳西州，非裔美国人占人口比例较高的邮政编码地区一种或多种沙门氏菌血清型的感染率显著更高。总之，我们的研究结果表明，社区层面的农业、环境和社会经济因素对于鼠伤寒沙门氏菌、肠炎沙门氏菌、纽波特沙门氏菌和爪哇那沙门氏菌的感染率可能很重要。
