TY - JOUR
T1 - The decline of typhoid and the rise of non-typhoid salmonellae and fungal infections in a changing HIV landscape
T2 - Bloodstream infection trends over 15 years in southern Vietnam
AU - Nga, Tran Vu Thieu
AU - Parry, Christopher M.
AU - Le, Thuy
AU - Lan, Nguyen Phu Huong
AU - Diep, To Song
AU - Campbell, James I.
AU - Hoang, Nguyen Van Minh
AU - Dung, Le Thi
AU - Wain, John
AU - Dolecek, Christiane
AU - Farrar, Jeremy J.
AU - Chau, Nguyen Van Vinh
AU - Hien, Tran Tinh
AU - Day, Jeremy N.
AU - Baker, Stephen
N1 - Funding Information:
This work was supported by The Wellcome Trust of Great Britain, Euston Road, London, United Kingdom. TL is supported by the Fogarty International Clinical Research Fellowship through the US National Institute of Health. SB is supported by an OAK Foundation Fellowship through Oxford University (Grant number OAKF9).
PY - 2012/1
Y1 - 2012/1
N2 - The etiological spectrum of bloodstream infections is variable between industrialized and developing countries and even within a defined location over time. We investigated trends in bloodstream infections at an infectious disease hospital in Ho Chi Minh City, Vietnam, from 1994-2008. Amongst 66. 111 blood cultures performed, a clinically relevant pathogen was isolated in 7645 episodes (positivity rate; 116/1000 cultures). Salmonella Typhi was the predominant pathogen until 2002; however, a considerable annual decline in the proportion of S. Typhi was observed (OR 0.6993, 95% CI [0.6885, 0.7103], p. < 0.0001). Conversely, there was a significant increase in the proportions of non-typhoidal Salmonella (NTS), Cryptococcus neoformans and Penicillium marneffei, concurrent with increasing HIV prevalence. These data document a substantial longitudinal shift in bloodstream infection etiology in southern Vietnam. We propose such changes are related to increasing economic prosperity and HIV prevalence, and this pattern marks a substantial change in the epidemiology of invasive salmonellosis in Southeast Asia.
AB - The etiological spectrum of bloodstream infections is variable between industrialized and developing countries and even within a defined location over time. We investigated trends in bloodstream infections at an infectious disease hospital in Ho Chi Minh City, Vietnam, from 1994-2008. Amongst 66. 111 blood cultures performed, a clinically relevant pathogen was isolated in 7645 episodes (positivity rate; 116/1000 cultures). Salmonella Typhi was the predominant pathogen until 2002; however, a considerable annual decline in the proportion of S. Typhi was observed (OR 0.6993, 95% CI [0.6885, 0.7103], p. < 0.0001). Conversely, there was a significant increase in the proportions of non-typhoidal Salmonella (NTS), Cryptococcus neoformans and Penicillium marneffei, concurrent with increasing HIV prevalence. These data document a substantial longitudinal shift in bloodstream infection etiology in southern Vietnam. We propose such changes are related to increasing economic prosperity and HIV prevalence, and this pattern marks a substantial change in the epidemiology of invasive salmonellosis in Southeast Asia.
KW - Antimicrobial resistance
KW - Bloodstream infections
KW - HIV infection
KW - Salmonella Typhi
KW - Vietnam
UR - http://www.scopus.com/inward/record.url?scp=83155160999&partnerID=8YFLogxK
U2 - 10.1016/j.trstmh.2011.10.004
DO - 10.1016/j.trstmh.2011.10.004
M3 - Article
C2 - 22137537
AN - SCOPUS:83155160999
SN - 0035-9203
VL - 106
SP - 26
EP - 34
JO - Transactions of the Royal Society of Tropical Medicine and Hygiene
JF - Transactions of the Royal Society of Tropical Medicine and Hygiene
IS - 1
ER -
