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Invasive Non-typhoidal Salmonella Infections in Asia: Clinical Observations, Disease Outcome and Dominant Serovars from an Infectious Disease Hospital in Vietnam.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Phu Huong Lan, Nguyen 
Le Thi Phuong, Tu 
Nguyen Huu, Hien 
Thuy, Le 
Mather, Alison E 

Abstract

Invasive non-typhoidal Salmonella (iNTS) infections are now a well-described cause of morbidity and mortality in children and HIV-infected adults in sub-Saharan Africa. In contrast, the epidemiology and clinical manifestations of iNTS disease in Asia are not well documented. We retrospectively identified >100 cases of iNTS infections in an infectious disease hospital in Southern Vietnam between 2008 and 2013. Clinical records were accessed to evaluate demographic and clinical factors associated with iNTS infection and to identify risk factors associated with death. Multi-locus sequence typing and antimicrobial susceptibility testing was performed on all organisms. Of 102 iNTS patients, 71% were HIV-infected, >90% were adults, 71% were male and 33% reported intravenous drug use. Twenty-six/92 (28%) patients with a known outcome died; HIV infection was significantly associated with death (p = 0.039). S. Enteritidis (Sequence Types (ST)11) (48%, 43/89) and S. Typhimurium (ST19, 34 and 1544) (26%, 23/89) were the most commonly identified serovars; S. Typhimurium was significantly more common in HIV-infected individuals (p = 0.003). Isolates from HIV-infected patients were more likely to exhibit reduced susceptibility against trimethoprim-sulfamethoxazole than HIV-negative patients (p = 0.037). We conclude that iNTS disease is a severe infection in Vietnam with a high mortality rate. As in sub-Saharan Africa, HIV infection was a risk factor for death, with the majority of the burden in this population found in HIV-infected adult men.

Description

Keywords

Adult, Aged, Anti-Infective Agents, Ceftriaxone, Drug Therapy, Combination, Female, Fluoroquinolones, HIV Infections, Hospitals, Humans, Logistic Models, Male, Middle Aged, Multilocus Sequence Typing, Multivariate Analysis, Retrospective Studies, Salmonella Infections, Salmonella enterica, Serogroup, Sex Factors, Trimethoprim, Sulfamethoxazole Drug Combination, Typhoid Fever, Vietnam

Journal Title

PLoS Negl Trop Dis

Conference Name

Journal ISSN

1935-2727
1935-2735

Volume Title

10

Publisher

Public Library of Science (PLoS)
Sponsorship
Biotechnology and Biological Sciences Research Council (BB/M014088/1)