Centers for Disease Control and Prevention, Atlanta, Georgia.
Clin Infect Dis. 2017 Oct 30;65(10):1624-1631. doi: 10.1093/cid/cix624.
Campylobacteriosis, a leading cause of foodborne illness in the United States, was not nationally notifiable until 2015. Data describing national patterns and trends are limited. We describe the epidemiology of Campylobacter infections in the United States during 2004-2012.
We summarized laboratory-confirmed campylobacteriosis data from the Nationally Notifiable Disease Surveillance System, National Outbreak Reporting System, National Antimicrobial Resistance Monitoring System, and Foodborne Diseases Active Surveillance Network.
During 2004-2012, 303520 culture-confirmed campylobacteriosis cases were reported. Average annual incidence rate (IR) was 11.4 cases/100000 persons, with substantial variation by state (range, 3.1-47.6 cases/100000 persons). IRs among patients aged 0-4 years were more than double overall IRs. IRs were highest among males in all age groups. IRs in western states and rural counties were higher (16.2/100000 and 14.2/100000, respectively) than southern states and metropolitan counties (6.8/100000 and 11.0/100000, respectively). Annual IRs increased 21% from 10.5/100000 during 2004-2006 to 12.7/100000 during 2010-2012, with the greatest increases among persons aged >60 years (40%) and in southern states (32%). The annual median number of Campylobacter outbreaks increased from 28 in 2004-2006 to 56 in 2010-2012; in total, 347 were reported. Antimicrobial susceptibility testing of isolates from 4793 domestic and 1070 travel-associated infections revealed that, comparing 2004-2009 to 2010-2012, ciprofloxacin resistance increased among domestic infections (12.8% vs 16.1%).
During 2004-2012, incidence of campylobacteriosis, outbreaks, and clinically significant antimicrobial resistance increased. Marked demographic and geographic differences exist. Our findings underscore the importance of national surveillance and understanding of risk factors to guide and target control measures.
空肠弯曲菌病是美国食源性疾病的主要病因，但直到 2015 年才在全国范围内进行报告。目前，关于全国范围内该疾病的模式和趋势的数据十分有限。本研究描述了 2004-2012 年美国空肠弯曲菌感染的流行病学特征。
我们对国家法定传染病监测系统、国家暴发报告系统、国家抗菌药物耐药监测系统和食源性疾病主动监测网络中实验室确诊的弯曲菌病数据进行了总结。
2004-2012 年，报告了 303520 例经培养确诊的空肠弯曲菌病。年发病率（IR）平均为 11.4 例/10 万人，各州之间存在显著差异（范围为 3.1-47.6 例/10 万人）。0-4 岁患者的 IR 是总 IR 的两倍多。所有年龄组中，男性的 IR 均最高。西部各州和农村县的 IR 较高（分别为 16.2/10 万人和 14.2/10 万人），而南部各州和大都市县的 IR 较低（分别为 6.8/10 万人和 11.0/10 万人）。2004-2006 年期间的年 IR 为 10.5/10 万人，2010-2012 年期间增加到 12.7/10 万人，增加了 21%，其中 60 岁以上人群（40%）和南部各州（32%）的增幅最大。每年弯曲菌病暴发的中位数数量从 2004-2006 年的 28 起增加到 2010-2012 年的 56 起；共报告了 347 起。对 4793 例国内感染和 1070 例旅行相关感染分离株进行的抗菌药物敏感性试验显示，与 2004-2009 年相比，2010-2012 年国内感染的环丙沙星耐药率增加（12.8%比 16.1%）。
2004-2012 年期间，空肠弯曲菌病的发病率、暴发和临床上显著的抗菌药物耐药性增加。在人口统计学和地理方面存在明显差异。本研究结果强调了全国性监测和了解危险因素的重要性，以指导和有针对性地采取控制措施。
