CIISA/Faculty of Veterinary Medicine of University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal.
National Reference Laboratory of Gastrointestinal Infections, National Health Institute Doutor Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal.
J Infect Public Health. 2018 Mar-Apr;11(2):178-182. doi: 10.1016/j.jiph.2017.06.002. Epub 2017 Jun 30.
Salmonella 1,4,[5],12:i:- is presently considered one of the major serovars responsible for human salmonellosis worldwide. Due to its recent emergence, studies assessing the demographic characterization and spatial epidemiology of salmonellosis 1,4,[5],12:i:- at local- or country-level are lacking. In this study, a analysis was conducted over a 10year period, from 2000 to the first quarter of 2011 at the Portuguese National Laboratory in Portugal mainland, with a total of 215 Salmonella 1,4,[5],12:i:- serotyped isolates obtained from human infections by a passive surveillance system. Data regarding source, year and month of sampling, gender, age, district and municipality of the patients were registered. Descriptive statistical analysis and a spatial scan statistic combined with a geographic information system were employed to characterize the epidemiology and identify spatial clusters. Results showed that most districts have reports of Salmonella 1,4,[5],12:i:-, with a higher number of cases at the Portuguese coastland, including districts like Porto (n=60, 27.9%), Lisboa (n=29, 13.5%) and Aveiro (n=28, 13.0%). An increased incidence was observed in the period from 2004 to 2011 and most infections occurred during May and October. Spatial analysis revealed 4 clusters of higher than expected infection rates. Three were located in the north of Portugal, including two at the coastland (Cluster 1 [RR=3.58, p≤0.001] and 4 [RR=10.42 p≤0.230]), and one at the countryside (Cluster 3 [RR=17.76, p≤0.001]). A larger cluster was detected involving the center and south of Portugal (Cluster 2 [RR=4.85, p≤0.001]). The present study was elaborated with data provided by a passive surveillance system, which may originate an underestimation of disease burden. However, this is the first report describing the incidence and the distribution of areas with higher risk of infection in Portugal, revealing that Salmonella 1,4,[5],12:i:- displayed a significant geographic clustering and these areas should be further evaluated to identify risk factors in order to establish prevention programs.
1,4,[5],12:i:- 血清型沙门氏菌目前被认为是全球范围内导致人类沙门氏菌病的主要血清型之一。由于其最近的出现，评估 1,4,[5],12:i:- 血清型沙门氏菌在地方或国家层面的人口特征和空间流行病学的研究尚缺乏。在这项研究中，对 2000 年至 2011 年第一季度期间葡萄牙大陆葡萄牙国家实验室的 215 株人类感染的沙门氏菌 1,4,[5],12:i:- 血清型进行了分析，这些菌株是通过被动监测系统获得的。记录了有关来源、采样年份和月份、性别、年龄、患者所在地区和城市的信息。采用描述性统计分析和空间扫描统计与地理信息系统相结合的方法，对流行病学特征进行了描述，并确定了空间聚集区。结果表明，大多数地区都有 1,4,[5],12:i:- 血清型沙门氏菌的报告，葡萄牙沿海地区报告的病例较多，包括波尔图（n=60，27.9%）、里斯本（n=29，13.5%）和阿威罗（n=28，13.0%）等地区。2004 年至 2011 年期间发病率有所增加，大多数感染发生在 5 月和 10 月。空间分析显示，有 4 个高于预期感染率的聚集区。其中 3 个位于葡萄牙北部，包括 2 个沿海地区（聚集区 1 [RR=3.58，p≤0.001]和 4 [RR=10.42，p≤0.230]）和 1 个农村地区（聚集区 3 [RR=17.76，p≤0.001]）。一个较大的聚集区涉及葡萄牙中部和南部（聚集区 2 [RR=4.85，p≤0.001]）。本研究采用的是被动监测系统提供的数据，这可能导致疾病负担的低估。然而，这是首次描述葡萄牙感染风险较高地区的发病率和分布情况的报告，表明 1,4,[5],12:i:- 血清型沙门氏菌具有显著的地理聚集性，这些地区应进一步评估，以确定危险因素，从而制定预防计划。
