Abstract
BackgroundSalmonella enterica is an important emerging cause of invasive infections worldwide. However, population-based data are limited. The objective of this study was to define the occurrence of S. enterica bacteremia in a large international population and to evaluate temporal and regional differences.MethodsWe conducted population-based laboratory surveillance for all salmonella bacteremias in six regions (annual population at risk 7.7 million residents) in Finland, Australia, Denmark, and Canada during 2000-2007.ResultsA total of 622 cases were identified for an annual incidence of 1.02 per 100,000 population. The incidence of typhoidal (serotypes Typhi and Paratyphi) and non-typhoidal (other serotypes) disease was 0.21 and 0.81 per 100,000/year. There was major regional and moderate seasonal and year to year variability with an increased incidence observed in the latter years of the study related principally to increasing rates of non-typhoidal salmonella bacteremias. Advancing age and male gender were significant risk factors for acquiring non-typhoidal salmonella bacteremia. In contrast, typhoidal salmonella bacteremia showed a decreasing incidence with advancing age and no gender-related excess risk.ConclusionsSalmonella enterica is an important emerging pathogen and regional determinants of risk merits further investigation.
Highlights
Salmonella enterica is an important emerging cause of invasive infections worldwide
The objective of this study was to define the occurrence of S. enterica bacteremia in a large international population and to evaluate temporal and regional differences
During the 8-year study, a total of 622 incident S. enterica bacteremias occurred during 61,748,478 person-years of surveillance; 370 (59%), 107 (17%), 78 (13%), 27 (4%), 21 (3%) and 19 (3%) cases were from Finland, Calgary, North Denmark, Sherbrooke, Victoria, and Canberra, respectively
Summary
Salmonella enterica is an important emerging cause of invasive infections worldwide. population-based data are limited. A major risk factor for acquiring typhoidal salmonella bacteremia is travel to an endemic region [8,9]. Non-typhoidal salmonella may frequently cause human disease in high income countries and in these cases risk factors include exposure to contaminated food, extremes of age, and the presence of a number of co-morbid illnesses [12,13,14,15,16]. In order to best establish the distribution and determinants of an infectious disease, population-based studies are optimal. This is because in these designs, selection bias is minimized by inclusion of all cases of disease fulfilling a case definition occurring among residents of a defined population. The objective of this study was to define the occurrence of S. enterica bacteremia in a large international population and to evaluate temporal and regional differences
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