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肯尼亚内罗毕一个城市非正式定居点中非伤寒沙门氏菌的环境持久性。

Environmental persistence of nontyphoidal Salmonella in an urban informal settlement in Nairobi, Kenya.

作者信息

Kebenei Collins K, Onyango David, Kering Kelvin, Mbae Cecilia, Kavai Susan, Muraya Michael, Wairimu Celestine, Odityo Georgina, Weber Kristin, Pietsch Michael, Pilz Tanja, Drechsel Oliver, Thürmer Andrea, Semmler Torsten, Fuchs Stephan, Simon Sandra, Flieger Antje, Wieler Lothar H, Kariuki Samuel

机构信息

Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.

School of Physical and Biological Sciences, Maseno University, Maseno, Kenya.

出版信息

PLoS One. 2025 Apr 28;20(4):e0321760. doi: 10.1371/journal.pone.0321760. eCollection 2025.

Abstract

Non-typhoidal Salmonella (NTS) presents a considerable health threat to children in low-resource settings, where clean water, sanitation, and hygiene are often inadequate. However, the environmental factors influencing NTS persistence and spread remain poorly understood. We utilized a case-control approach to investigate environmental factors associated with NTS infection in children living in Nairobi's informal settlements between August 2022 and July 2023. Stool samples were collected from febrile children, with or without diarrhea, who visited healthcare facilities. The study included 42 laboratory-confirmed NTS-positive cases and 42 NTS-negative children from the same community. Environmental samples, including drinking water, open drains, soil, and household effluent, were collected from both case and control households, in addition to raw sewage from main sewer-line convergence points. Conventional microbiological culture and quantitative Polymerase Chain Reaction techniques were employed for NTS detection, with genomic sequencing used for strain characterization. Environmental samples from case households showed a higher NTS contamination rate of 33.3% (42/126) compared to control households of 7.2% (9/126). Higher odds of NTS infection in children were associated with household environmental factors, particularly exposure to household effluent (OR = 7.7, 95% CI: 2.18-34.82, p = 0.0005), drinking water (OR = 6.4, 95% CI: 1.57-37.76, p = 0.0055), and soil (OR = 5.4, 95% CI: 1.01-54.28, p = 0.0485). Genomic analysis revealed a common strain, Salmonella Enteritidis ST11, in clinical and environmental isolates. These findings highlight the plausible role of the household environment as a reservoir for NTS, perpetuating infection cycles within the community. Addressing this challenge requires a multifaceted approach, including improved sanitation infrastructure, environmental monitoring, and integrated public health interventions to reduce NTS exposure and transmission in high-risk populations.

摘要

非伤寒沙门氏菌(NTS)对资源匮乏地区的儿童构成了相当大的健康威胁,在这些地区,清洁水、卫生设施和个人卫生往往不足。然而,影响NTS持续存在和传播的环境因素仍知之甚少。我们采用病例对照方法,调查了2022年8月至2023年7月期间居住在内罗毕非正式定居点的儿童中与NTS感染相关的环境因素。从前往医疗机构就诊的发热儿童(无论有无腹泻)中采集粪便样本。该研究包括42例实验室确诊的NTS阳性病例和来自同一社区的42例NTS阴性儿童。除了从主要下水道汇合点采集的未经处理的污水外,还从病例和对照家庭中采集了环境样本,包括饮用水、露天排水沟、土壤和家庭污水。采用传统微生物培养和定量聚合酶链反应技术进行NTS检测,并使用基因组测序进行菌株鉴定。与对照家庭7.2%(9/126)的NTS污染率相比,病例家庭的环境样本显示出更高的NTS污染率,为33.3%(42/126)。儿童感染NTS的较高几率与家庭环境因素有关,特别是接触家庭污水(比值比=7.7,95%置信区间:2.18-34.82,p=0.0005)、饮用水(比值比=6.4,95%置信区间:1.57-37.76,p=0.0055)和土壤(比值比=5.4,95%置信区间:1.01-54.28,p=0.0485)。基因组分析在临床和环境分离株中发现了一种常见菌株,肠炎沙门氏菌ST11。这些发现凸显了家庭环境作为NTS储存库的可能作用,使社区内的感染循环持续存在。应对这一挑战需要采取多方面的方法,包括改善卫生基础设施、环境监测以及综合公共卫生干预措施,以减少高风险人群接触和传播NTS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f82/12036858/cab9a4fdfebe/pone.0321760.g001.jpg

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