Department of Environmental and Global Health, Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States.
Animal Sciences Department, Emerging Pathogens Institute and Food Systems Institute, University of Florida, Gainesville, FL, United States.
Front Public Health. 2021 Jan 11;8:603005. doi: 10.3389/fpubh.2020.603005. eCollection 2020.
Non-typhoidal infections cause a high disease burden in the United States with an estimated 1.2 million illnesses annually. The state of Florida consistently has a relatively high incidence compared to other states in the United States. Nevertheless, studies regarding the epidemiology of nontyphoidal salmonellosis and its spatial and temporal patterns in Florida were rarely reported. We examined the spatial and temporal patterns of 62,947 salmonellosis cases reported to FL Health Charts between 2009 and 2018. Dominant serotypes circulating in Florida were also explored using whole genome sequencing (WGS) based serotype-prediction for 2,507 isolates sequenced by the Florida Department of Health during 2017 and 2018. The representativeness of laboratory-sequenced isolates for reported cases was determined by regression modeling. The annual incidence rate of salmonellosis decreased from 36.0 per 100,000 population in 2009 to 27.8 per 100,000 in 2016, and gradually increased in 2017 and 2018. Increased use of culture-independent testing did not fully explain this increase. The highest incidence rate was observed in children, contributing 40.9% of total reported cases during this period. A seasonal pattern was observed with the incidence peaking in September and October, later than the national average pattern. Over these 10 years, the Northeast and Northwest regions of the state had higher reported incidence rates, while reported rates in the Southeast and South were gradually increasing over time. Serotypes were predicted based on WGS data in the EnteroBase platform. The top-five most prevalent serotypes in Florida during 2017-2018 were Enteritidis, Newport, Javiana, Sandiego and Braenderup. The highest percentage of isolates was from children under 5 years of age (41.4%), and stool (84.7%) was the major source of samples. A zero-inflated negative binomial regression model showed that the reported case number was a strong predictor for the number of lab-sequenced isolates in individual counties, and the geospatial distribution of sequenced isolates was not biased by other factors such as age group. The spatial and temporal patterns identified in this study along with the prevalence of different serotypes will be helpful for the development of efficient prevention and control strategies for salmonellosis in Florida.
非伤寒型感染在美国造成了很高的疾病负担，估计每年有 120 万人患病。佛罗里达州的发病率一直相对较高，与美国其他州相比。然而，关于佛罗里达州非伤寒型沙门氏菌病的流行病学及其时空模式的研究很少有报道。我们研究了 2009 年至 2018 年期间向佛罗里达州卫生图表报告的 62947 例沙门氏菌病病例的时空模式。还使用全基因组测序（WGS）探索了在佛罗里达州循环的主要血清型，根据佛罗里达州卫生部在 2017 年和 2018 年对 2507 株分离株进行的基于 WGS 的血清型预测，对这些分离株进行了研究。通过回归建模确定了实验室测序分离株对报告病例的代表性。沙门氏菌病的年发病率从 2009 年的每 10 万人 36.0 例降至 2016 年的每 10 万人 27.8 例，2017 年和 2018 年逐渐上升。非培养依赖性检测的使用增加并没有完全解释这种增加。发病率最高的是儿童，在这段时间内占总报告病例的 40.9%。观察到季节性模式，发病率在 9 月和 10 月达到峰值，晚于全国平均模式。在这 10 年中，该州的东北部和西北部地区报告的发病率较高，而东南部和南部地区的报告发病率随着时间的推移逐渐增加。血清型是根据 EnteroBase 平台上的 WGS 数据预测的。2017-2018 年佛罗里达州最常见的五种血清型是肠炎、纽波特、雅文那、圣地亚哥和布兰登鲁普。最高比例的分离株来自 5 岁以下儿童（41.4%），粪便（84.7%）是主要样本来源。零膨胀负二项回归模型表明，报告病例数是各县实验室测序分离株数的有力预测指标，测序分离株的地理空间分布不受年龄组等其他因素的影响。本研究确定的时空模式以及不同血清型的流行情况将有助于制定佛罗里达州沙门氏菌病的有效预防和控制策略。
