Le Thi Phuong Tu, Rattanavong Sayaphet, Vongsouvath Manivanh, Davong Viengmon, Phu Huong Lan Nguyen, Campbell James I, Darton Thomas C, Thwaites Guy E, Newton Paul N, Dance David A B, Baker Stephen
Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, 764 Vo Van Kiet, Quan 5, Ho Chi Minh City, Vietnam.
Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane Capital, Lao People's Democratic Republic.
Trans R Soc Trop Med Hyg. 2017 Sep 1;111(9):418-424. doi: 10.1093/trstmh/trx076.
Invasive non-typhoidal Salmonella (iNTS) disease is a well-described cause of mortality in children and human immunodeficiency virus (HIV)-infected adults in sub-Saharan Africa. Additionally, there is an ill-defined burden of iNTS disease in Southeast Asia.
Aiming to investigate the causative serovars of non-invasive and iNTS disease and their associated antimicrobial susceptibility profiles in the Lao People's Democratic Republic, we performed multilocus sequence typing and antimicrobial susceptibility profiling on 168 NTS (63 blood and 105 faecal) organisms isolated in Lao between 2000 and 2012.
Six different serovars were isolated from blood; Salmonella enterica serovar Enteritidis (n=28), S. enterica serovar Typhimurium (n=19) and S. enterica serovar Choleraesuis (n=11) accounted for >90% (58/63) of the iNTS disease cases. In contrast, the isolates from diarrhoeal faeces were comprised of 18 different serovars, the mostly commonly identified being S. enterica Typhimurium (n=28), S. enterica Weltevreden (n=14) and S. enterica Stanley (n=15). S. enterica Enteritidis and S. enterica Choleraesuis were significantly more associated with systemic disease than diarrhoeal disease in this patient group (p<0.001).
We find a differing distribution of Salmonella sequence types/serovars between those causing iNTS disease and non-invasive disease in Lao. We conclude that there is a small but not insignificant burden of iNTS disease in Lao. Further clinical and epidemiological investigations are required to assess mortality and the role of comorbidities such as HIV.
侵袭性非伤寒沙门氏菌（iNTS）病是撒哈拉以南非洲儿童和人类免疫缺陷病毒（HIV）感染成人死亡的一个常见原因。此外，东南亚iNTS病的负担尚不明确。
为了调查老挝人民民主共和国非侵袭性和iNTS病的致病血清型及其相关的抗菌药物敏感性概况，我们对2000年至2012年期间在老挝分离出的168株非伤寒沙门氏菌（63株血液分离株和105株粪便分离株）进行了多位点序列分型和抗菌药物敏感性分析。
从血液中分离出六种不同的血清型；肠炎沙门氏菌肠炎血清型（n = 28）、鼠伤寒沙门氏菌血清型（n = 19）和猪霍乱沙门氏菌血清型（n = 11）占iNTS病病例的90%以上（58/63）。相比之下，腹泻粪便分离株由18种不同的血清型组成，最常见的是鼠伤寒沙门氏菌（n = 28）、韦尔特弗里登沙门氏菌（n = 14）和斯坦利沙门氏菌（n = 15）。在该患者组中，肠炎沙门氏菌和猪霍乱沙门氏菌与全身性疾病的相关性显著高于腹泻疾病（p<0.001）。
我们发现老挝导致iNTS病和非侵袭性疾病的沙门氏菌序列类型/血清型分布不同。我们得出结论，老挝iNTS病的负担虽小但并非微不足道。需要进一步的临床和流行病学调查来评估死亡率以及HIV等合并症的作用。
