Paphitis Katherine, Pearl David L, Berke Olaf, McEwen Scott A, Trotz-Williams Lise
Department of Population Medicine, University of Guelph, Ontario Veterinary College, Guelph, ON, Canada.
Infection Prevention and Control, Public Health Ontario, Toronto, ON, Canada.
Zoonoses Public Health. 2020 Aug;67(5):484-495. doi: 10.1111/zph.12709. Epub 2020 May 4.
Salmonella Heidelberg and Salmonella Typhimurium are among the most common serotypes responsible for human salmonellosis in Ontario. Introduction of the Ontario Investigation Tools (OIT) in 2014 allowed for standardized case investigation and reporting. This study compared the risk factors and symptomatology for sporadic S. Heidelberg and S. Typhimurium cases reported in Ontario in 2015, following implementation of the OIT. Multilevel logistic regression models were applied to assess associations between serotype and individual-level demographic characteristics, exposures and symptoms for sporadic confirmed cases of S. Heidelberg and S. Typhimurium in Ontario in 2015. There were 476 sporadic cases of S. Typhimurium (n = 278) and S. Heidelberg (n = 198) reported in Ontario in 2015. There were significant associations between the odds of the isolate from a case being one of these serotypes, and travel, consumption of sprouts (any type), contact with reptiles and development of malaise, fever or bloody diarrhoea. The S. Typhimurium and S. Heidelberg cases differed in both symptom presentation and risk factors for illness. Case-case comparisons of Salmonella serotypes have some advantages over case-control studies in that these are less susceptible to selection and recall bias while allowing for rapid comparison of cases to identify potential high-risk exposures that are unique to one of the serotypes when compared to the other. Comparing cases of two different Salmonella serotypes can help to highlight risk factors that may be uniquely associated with one serotype, or more strongly associated with one serotype compared to another. This information may be useful for understanding relative source attribution between common serotypes of Salmonella.
海德堡沙门氏菌和鼠伤寒沙门氏菌是安大略省导致人类沙门氏菌病的最常见血清型。2014年引入的安大略调查工具（OIT）实现了标准化的病例调查和报告。本研究比较了在实施OIT后，2015年安大略省报告的散发性海德堡沙门氏菌和鼠伤寒沙门氏菌病例的风险因素和症状学。应用多水平逻辑回归模型评估血清型与2015年安大略省散发性确诊的海德堡沙门氏菌和鼠伤寒沙门氏菌病例的个体层面人口统计学特征、暴露因素和症状之间的关联。2015年安大略省报告了476例散发性鼠伤寒沙门氏菌病例（n = 278）和海德堡沙门氏菌病例（n = 198）。病例分离株为这些血清型之一的几率与旅行、食用（任何类型的）豆芽、接触爬行动物以及出现不适、发热或血性腹泻之间存在显著关联。鼠伤寒沙门氏菌病例和海德堡沙门氏菌病例在症状表现和发病风险因素方面均有所不同。沙门氏菌血清型的病例对照比较相对于病例对照研究具有一些优势，因为这些比较不易受到选择偏倚和回忆偏倚的影响，同时允许快速比较病例，以识别与另一种血清型相比某一种血清型特有的潜在高风险暴露因素。比较两种不同沙门氏菌血清型的病例有助于突出可能与某一种血清型独特相关或与另一种血清型相比与某一种血清型关联更强的风险因素。这些信息可能有助于理解沙门氏菌常见血清型之间的相对来源归因。
