Invasive Nontyphoidal<i>Salmonella</i>Infections Among Children in Mali, 2002–2014: Microbiological and Epidemiologic Features Guide Vaccine Development

Tapia, Milagritos D.; Tennant, Sharon M.; Bornstein, Kristin; Onwuchekwa, Uma; Tamboura, Boubou; Maïga, Almoustapha Issiaka; Sylla, Mamadou; Sissoko, Seydou; Kourouma, Nana; Touré, Aliou; Malle, Dramane; Livio, Sofie; Sow, Samba O.; Levine, Myron M.

doi:10.1093/cid/civ729

Cited by 49 publications

(71 citation statements)

References 20 publications

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“…[18] In the Democratic Republic of the Congo, MDR occurs in >80% of these 2 serotypes. [19] Interestingly, MDR was low in Salmonella Dublin in Mali, [4] similar to our findings. The predominance of Salmonella Typhimurium and Salmonella Enteritidis in Africa has highlighted these pathogens as primary serotypes for Salmonella vaccine development.…”

Section: Discussionsupporting

confidence: 88%

“…We additionally identified increased numbers of Salmonella Isangi and Salmonella Dublin. Salmonella Enteritidis and Salmonella Dublin isolate were predominantly susceptible to the antimicrobials tested, but in common with other African studies, MDR was common in Salmonella Typhimurium [4,5] and Salmonella Isangi. Reports from Mali indicate that MDR occurred in >90% and 40% of Salmonella Typhimurium and Salmonella Enteritidis, respectively.…”

Section: Discussionsupporting

confidence: 74%

“…Reports from Mali indicate that MDR occurred in >90% and 40% of Salmonella Typhimurium and Salmonella Enteritidis, respectively. [4] Conversely, reports from Kenya suggest that 36% to 77% of invasive Salmonella Typhimurium [5,18] and 30% of invasive Salmonella Enteritidis are multidrug resistant. [18] In the Democratic Republic of the Congo, MDR occurs in >80% of these 2 serotypes.…”

Section: Discussionmentioning

confidence: 99%

“…[6] A number of studies have highlighted the high health burden of iNTS in children, frequently associated with malaria and malnutrition. [3,5] Much work has also focused on microbiological aspects of iNTS, including serotype and multidrug resistance (MDR), [4,5] or iNTS disease burden. [7] Several have called for development of nontyphoidal Salmonella vaccines.…”

Section: Introductionmentioning

confidence: 99%

“…[7] Several have called for development of nontyphoidal Salmonella vaccines. [8] Although there have been reports of decreasing incidence of iNTS infections in some parts of Africa, [7,9] mortality rates among persons with iNTS infections remain high [4,5,9] and factors associated with mortality among persons infected with iNTS are not well understood. A better understanding of disability and associated mortality of iNTS infections will inform decisions for control and prevention of iNTS infections.…”

Section: Introductionmentioning

confidence: 99%

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Clinical and microbiological features of invasive nontyphoidal Salmonella associated with HIV-infected patients, Gauteng Province, South Africa

Keddy

Musekiwa²,

Sooka

et al. 2017

Medicine

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The aim of this study was to define factors associated with HIV-infected versus uninfected patients with invasive nontyphoidal Salmonella (iNTS) and factors associated with mortality, which are inadequately described in Africa.Laboratory-based surveillance for iNTS was undertaken. At selected sentinel sites, clinical data (age, sex, HIV status, severity of illness, and outcome) were collected.Surveillance was conducted in Gauteng, South Africa, from 2003 to 2013. Clinical and microbiological differences between HIV-infected and uninfected patients were defined and risk factors for mortality established.Of 4886 iNTS infections in Gauteng from 2003 to 2013, 3106 (63.5%) were diagnosed at sentinel sites. Among persons with iNTS infections, more HIV-infected persons were aged ≥5 years (χ2 = 417.6; P < 0.001) and more HIV-infected children were malnourished (χ2 = 5.8; P = 0.02). Although 760 (30.6%) patients died, mortality decreased between 2003 [97/263 (36.9%)] and 2013 [926/120 (21.7%)]. On univariate analysis, mortality was associated with patients aged 25 to 49 years [odds ratio (OR) = 2.2; 95% confidence interval (CI) = 1.7–2.7; P < 0.001 and ≥50 years (OR = 3.0; 95% CI = 2.2–4.1; P < 0.001) compared with children < 5 years, HIV-infected patients (OR = 2.4; 95% CI = 1.7–3.4; P < 0.001), and severe illness (OR = 5.4; 95% CI = 3.6–8.1; P < 0.001). On multivariate analysis, mortality was associated with patients aged ≥50 years [adjusted OR (AOR) = 3.6, 95% CI = 2.1–6.1, P < 0.001] and severe illness (AOR = 6.3; 95% CI = 3.8–10.5; P < 0.001).Mortality due to iNTS in Gauteng remains high primarily due to disease severity. Interventions must be aimed at predisposing conditions, including HIV, other immune-suppressive conditions, and malignancy.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical and microbiological features of invasive nontyphoidal Salmonella associated with HIV-infected patients, Gauteng Province, South Africa

Keddy

Musekiwa²,

Sooka

et al. 2017

Medicine

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Clinical profiles and antimicrobial resistance patterns of invasive Salmonella infections in children in China

Song

Shan²,

Qiu³

et al. 2022

Eur J Clin Microbiol Infect Dis

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Invasive Salmonella infections result in a significant burden of disease including morbidity, mortality, and financial cost in many countries. Besides typhoid fever, the clinical impact of non-typhoid Salmonella infections is increasingly recognized with the improvement of laboratory detection capacity and techniques. A retrospective multicenter study was conducted to analyze the clinical profiles and antimicrobial resistance patterns of invasive Salmonella infections in hospitalized children in China during 2016–2018. A total of 130 children with invasive Salmonella infections were included with the median age of 12 months (range: 1–144 months). Seventy-nine percent of cases occurred between May and October. Pneumonia was the most common comorbidity in 33 (25.4%) patients. Meningitis and septic arthritis caused by nontyphoidal Salmonella (NTS) infections occurred in 12 (9.2%) patients and 5 (3.8%) patients. Patients < 12 months (OR: 16.04) and with septic shock (OR: 23.4), vomit (OR: 13.33), convulsion (OR: 15.86), C-reactive protein (CRP) ≥ 40 g/L (OR: 5.56), and a higher level of procalcitonin (PCT) (OR: 1.05) on admission were statistically associated to an increased risk of developing meningitis. Compared to 114 patients with NTS infections, 16 patients with typhoid fever presented with higher levels of CRP and PCT (P < 0.05). The rates of resistance to ampicillin, sulfamethoxazole/trimethoprim, ciprofloxacin, and ceftriaxone among Salmonella Typhi and NTS isolates were 50% vs 57.3%, 9.1% vs 24.8%, 0% vs 11.2%, and 0% vs 9.9%, respectively. NTS has been the major cause of invasive Salmonella infections in Chinese children and can result in severe diseases. Antimicrobial resistance among NTS was more common.

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Diversity and antimicrobial drug resistance of non-typhoid Salmonella serotypes isolated in lettuce, irrigation water and clinical samples in Burkina Faso

Somda

Bonkoungou²,

Sambe-Ba

et al. 2021

Journal of Agriculture and Food Research

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Invasive NontyphoidalSalmonellaInfections Among Children in Mali, 2002–2014: Microbiological and Epidemiologic Features Guide Vaccine Development

Cited by 49 publications

References 20 publications

Clinical and microbiological features of invasive nontyphoidal Salmonella associated with HIV-infected patients, Gauteng Province, South Africa

Clinical and microbiological features of invasive nontyphoidal Salmonella associated with HIV-infected patients, Gauteng Province, South Africa

Clinical profiles and antimicrobial resistance patterns of invasive Salmonella infections in children in China

Diversity and antimicrobial drug resistance of non-typhoid Salmonella serotypes isolated in lettuce, irrigation water and clinical samples in Burkina Faso

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