加纳农村侵袭性血流感染和水源中肠炎沙门氏菌的特征分析。
Characterization of Salmonella enterica from invasive bloodstream infections and water sources in rural Ghana.
作者信息
Dekker Denise, Krumkamp Ralf, Eibach Daniel, Sarpong Nimako, Boahen Kennedy Gyau, Frimpong Michael, Fechtner Elina, Poppert Sven, Hagen Ralf Matthias, Schwarz Norbert Georg, Adu-Sarkodie Yaw, Owusu-Dabo Ellis, Im Justin, Marks Florian, Frickmann Hagen, May Jürgen
机构信息
Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str. 74, D-20359, Hamburg, Germany.
German Center for Infection Research (DZIF), Hamburg-Borstel, Lübeck, Germany.
出版信息
BMC Infect Dis. 2018 Jan 19;18(1):47. doi: 10.1186/s12879-018-2957-4.
BACKGROUND
Non-typhoidal Salmonella (NTS) cause the majority of bloodstream infections in Ghana, however the mode of transmission and source of invasive NTS in Africa are poorly understood. This study compares NTS from water sources and invasive bloodstream infections in rural Ghana.
METHODS
Blood from hospitalised, febrile children and samples from drinking water sources were analysed for Salmonella spp. Strains were serotyped to trace possible epidemiological links between human and water-derived isolates.. Antibiotic susceptibility testing was performed, RESULTS: In 2720 blood culture samples, 165 (6%) NTS were isolated. S. Typhimurium (70%) was the most common serovar followed by S. Enteritidis (8%) and S. Dublin (8%). Multidrug resistance (MDR) was found in 95 (58%) NTS isolates, including five S. Enteritidis. One S. Typhimurium showed reduced fluroquinolone susceptibility. In 511 water samples, 19 (4%) tested positive for S. enterica with two isolates being resistant to ampicillin and one isolate being resistant to cotrimoxazole. Serovars from water samples were not encountered in any of the clinical specimens.
CONCLUSION
Water analyses demonstrated that common drinking water sources were contaminated with S. enterica posing a potential risk for transmission. However, a link between S. enterica from water sources and patients could not be established, questioning the ability of water-derived serovars to cause invasive bloodstream infections.
背景
非伤寒沙门氏菌（NTS）导致加纳大多数血流感染，但非洲侵袭性NTS的传播方式和来源尚不清楚。本研究比较了加纳农村水源中的NTS与侵袭性血流感染情况。
方法
对住院发热儿童的血液和饮用水源样本进行沙门氏菌属分析。对菌株进行血清分型，以追踪人类和水源分离株之间可能的流行病学联系。进行抗生素敏感性测试。
结果
在2720份血培养样本中，分离出165株（6%）NTS。鼠伤寒沙门氏菌（70%）是最常见的血清型，其次是肠炎沙门氏菌（8%）和都柏林沙门氏菌（8%）。在95株（58%）NTS分离株中发现多重耐药（MDR），包括5株肠炎沙门氏菌。1株鼠伤寒沙门氏菌对氟喹诺酮的敏感性降低。在511份水样中，19份（约4%）肠炎沙门氏菌检测呈阳性，2株对氨苄西林耐药，1株对复方新诺明耐药。临床标本中未发现水样中的血清型。
结论
水分析表明，常见饮用水源被肠炎沙门氏菌污染，存在潜在传播风险。然而，无法确定水源中的肠炎沙门氏菌与患者之间的联系，这对水源血清型导致侵袭性血流感染的能力提出了质疑。
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