2015-2018 年疫苗对非洲腹泻影响研究（VIDA）期间粪便中的沙门氏菌流行率。

Prevalence of Salmonella in Stool During the Vaccine Impact on Diarrhea in Africa (VIDA) Study, 2015-2018.

机构信息

Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.

Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.

出版信息

Clin Infect Dis. 2023 Apr 19;76(76 Suppl1):S87-S96. doi: 10.1093/cid/ciac985.

DOI:10.1093/cid/ciac985

PMID:37074429

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10116559/

Abstract

BACKGROUND

Non-typhoidal Salmonella (NTS) is a common cause of gastroenteritis in young children, with limited data on NTS serovars and antimicrobial resistance in Africa.

METHODS

We determined the prevalence of Salmonella spp. and frequency of antimicrobial resistance among serovars identified in stools of 0-59 month-old children with moderate-to-severe diarrhea (MSD) and controls enrolled in the Vaccine Impact on Diarrhea in Africa (VIDA) Study in The Gambia, Mali, and Kenya in 2015-2018, and compared with data from the Global Enteric Multicenter Study (GEMS; 2007-2010) and the GEMS-1A study (2011). Salmonella spp. was detected by quantitative real-time PCR (qPCR) and culture-based methods. Identification of serovars was determined by microbiological methods.

RESULTS

By qPCR, the prevalence of Salmonella spp. among MSD cases was 4.0%, 1.6%, and 1.9% and among controls was 4.6%, 2.4%, and 1.6% in The Gambia, Mali, and Kenya, respectively, during VIDA. We observed year-to-year variation in serovar distribution and variation between sites. In Kenya, Salmonella enterica serovar Typhimurium decreased (78.1% to 23.1%; P < .001) among cases and controls from 2007 to 2018, whereas serogroup O:8 increased (8.7% to 38.5%; P = .04). In The Gambia, serogroup O:7 decreased from 2007 to 2018 (36.3% to 0%; P = .001) but S. enterica serovar Enteritidis increased during VIDA (2015 to 2018; 5.9% to 50%; P = .002). Only 4 Salmonella spp. were isolated in Mali during all 3 studies. Multidrug resistance was 33.9% in Kenya and 0.8% in The Gambia across all 3 studies. Ceftriaxone resistance was only observed in Kenya (2.3%); NTS isolates were susceptible to ciprofloxacin at all sites.

CONCLUSIONS

Understanding variability in serovar distribution will be important for the future deployment of vaccines against salmonellosis in Africa.

摘要

背景

非伤寒沙门氏菌（NTS）是导致幼儿肠胃炎的常见原因，但非洲有关 NTS 血清型和抗生素耐药性的数据有限。

方法

我们测定了 2015 年至 2018 年期间在冈比亚、马里和肯尼亚参加疫苗对非洲腹泻影响（VIDA）研究的中重度腹泻（MSD）患儿和对照者粪便中沙门氏菌属的流行率和鉴定血清型的抗生素耐药频率，并与全球肠道多中心研究（GEMS；2007-2010 年）和 GEMS-1A 研究（2011 年）的数据进行了比较。沙门氏菌属通过定量实时 PCR（qPCR）和基于培养的方法检测。血清型的鉴定通过微生物学方法确定。

结果

通过 qPCR，VIDA 期间，MSD 病例和对照中沙门氏菌属的流行率分别为冈比亚 4.0%、1.6%和 1.9%，马里 4.6%、2.4%和 1.6%，肯尼亚 1.6%、2.4%和 1.9%。我们观察到各年血清型分布和各地点之间的变化。在肯尼亚，2007 年至 2018 年期间，病例和对照中肠炎沙门氏菌血清型 Typhimurium 的比例从 78.1%下降到 23.1%（P<.001），而 O 组：8 的比例从 8.7%增加到 38.5%（P=.04）。在冈比亚，2007 年至 2018 年期间，O 组：7 的比例从 36.3%下降到 0%（P=.001），但肠沙门氏菌血清型 Enteritidis 在 VIDA 期间增加（2015 年至 2018 年；5.9%至 50%；P=.002）。在马里，所有 3 项研究期间仅分离到 4 株沙门氏菌。在所有 3 项研究中，肯尼亚的多重耐药率为 33.9%，冈比亚为 0.8%。在所有地点，头孢曲松耐药性仅在肯尼亚观察到（2.3%）；NTS 分离株对环丙沙星均敏感。