Rohringer Andreas, Veneti Lamprini, Stüken Anke, van Boetzelaer Elburg, Lund Hilde M, Nordeng Zuzana, MacDonald Emily, Naseer Umaer
Norwegian Institute of Public Health (NIPH), Oslo, Norway.
European Programme for Public Health Microbiology (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
Eur J Clin Microbiol Infect Dis. 2025 May 27. doi: 10.1007/s10096-025-05165-x.
Non-typhoidal Salmonella (NTS) gastroenteritis in humans is typically self-limited, resolving within 48-72 h. However, some infections result in a carrier state characterised by persistent gut colonisation and long-term shedding (LTS). This study aimed to investigate risk factors associated with LTS of NTS in humans.
Salmonellosis cases reported to the Norwegian surveillance system in 2019 were invited to participate. Participants submitted a follow-up stool sample and a questionnaire five weeks after initial sampling (detecting infection). Stool samples were cultured, and isolates were sequenced to determine genotype, serotype and antimicrobial resistance genotype. NTS cases were classified as LTS if the isolates from both samples differed by ≤ 5 alleles. Adjusted odds ratios (aORs) with 95% confidence intervals (95%CIs) were calculated using logistic regression to investigate potential risk factors associated with LTS.
Of 1,094 reported cases, 255 (23%) with NTS participated; 24% were classified as LTS. Children aged 0-5 years were 6.7 times more likely to exhibit LTS compared to adults aged 18-44 years (aOR = 6.71, 95%CI:1.67-26.94). Participants who received regular medication and those following a lactose-free diet were 2.2 (aOR = 2.17, 95%CI:1.02-4.64) and 7.2 (aOR = 7.24, 95%CI:1.48-35.40) times more likely to exhibit LTS than those who did not, respectively. Participants with S. Agbeni or S. Bron were 6 times more likely to exhibit LTS compared to S. Typhimurium cases (aOR = 6.29, 95%CI:1.40-28.16).
Observed risk factors associated with LTS included young age, regular medication use, lactose-free diet, and specific Salmonella serotypes. Further research is needed to increase knowledge regarding LTS and inform infection control measures.
人类非伤寒沙门氏菌（NTS）胃肠炎通常为自限性疾病，在48 - 72小时内可痊愈。然而，一些感染会导致携带状态，其特征为肠道持续定植和长期排菌（LTS）。本研究旨在调查人类NTS长期排菌相关的危险因素。
邀请2019年向挪威监测系统报告的沙门氏菌病病例参与研究。参与者在初次采样（检测到感染）五周后提交一份随访粪便样本和一份问卷。对粪便样本进行培养，并对分离株进行测序以确定基因型、血清型和抗菌药物耐药基因型。如果两份样本的分离株等位基因差异≤5个，则NTS病例被分类为长期排菌。使用逻辑回归计算调整后的优势比（aOR）及其95%置信区间（95%CI），以调查与长期排菌相关的潜在危险因素。
在1094例报告病例中，255例（23%）为NTS感染并参与研究；24%被分类为长期排菌。0 - 5岁儿童出现长期排菌的可能性是18 - 44岁成年人的6.7倍（aOR = 6.71，95%CI：1.67 - 26.94）。接受常规药物治疗的参与者和遵循无乳糖饮食的参与者出现长期排菌的可能性分别是未接受常规药物治疗者和未遵循无乳糖饮食者的2.2倍（aOR = 2.17，95%CI：1.02 - 4.64）和7.2倍（aOR = 7.24，95%CI：1.48 - 35.40）。与鼠伤寒沙门氏菌病例相比，阿贝尼沙门氏菌或布隆沙门氏菌感染的参与者出现长期排菌的可能性高6倍（aOR = 6.29，95%CI：1.40 - 28.16）。
观察到的与长期排菌相关的危险因素包括年龄小、常规药物使用、无乳糖饮食和特定的沙门氏菌血清型。需要进一步研究以增加对长期排菌的了解并为感染控制措施提供依据。
