Invasive Non-typhoidal Salmonella Infections in Asia: Clinical Observations, Disease Outcome and Dominant Serovars from an Infectious Disease Hospital in Vietnam. Phu Huong Lan, N., Le Thi Phuong, T., Nguyen Huu, H., Thuy, L., Mather, A. E., Park, S. E., Marks, F., Thwaites, G. E., Van Vinh Chau, N., Thompson, C. N., & Baker, S. PLoS neglected tropical diseases, 10(8):e0004857, August, 2016.
doi  abstract   bibtex   
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 \textgreater100 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, \textgreater90% 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.
@article{phu_huong_lan_invasive_2016,
	title = {Invasive {Non}-typhoidal {Salmonella} {Infections} in {Asia}: {Clinical} {Observations}, {Disease} {Outcome} and {Dominant} {Serovars} from an {Infectious} {Disease} {Hospital} in {Vietnam}.},
	volume = {10},
	issn = {1935-2735 1935-2727},
	doi = {10.1371/journal.pntd.0004857},
	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 {\textgreater}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, {\textgreater}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.},
	language = {eng},
	number = {8},
	journal = {PLoS neglected tropical diseases},
	author = {Phu Huong Lan, Nguyen and Le Thi Phuong, Tu and Nguyen Huu, Hien and Thuy, Le and Mather, Alison E. and Park, Se Eun and Marks, Florian and Thwaites, Guy E. and Van Vinh Chau, Nguyen and Thompson, Corinne N. and Baker, Stephen},
	month = aug,
	year = {2016},
	pmid = {27513951},
	pmcid = {PMC4981332},
	keywords = {Adult, Aged, Anti-Infective Agents/therapeutic use, Ceftriaxone/therapeutic use, Drug Therapy, Combination, Female, Fluoroquinolones/therapeutic use, HIV Infections/epidemiology/*microbiology, Hospitals, Humans, Logistic Models, Male, Middle Aged, Multilocus Sequence Typing, Multivariate Analysis, Retrospective Studies, Salmonella Infections/drug therapy/*epidemiology/*mortality, Salmonella enterica/classification/isolation \& purification, Serogroup, Sex Factors, Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use, Typhoid Fever, Vietnam/epidemiology},
	pages = {e0004857},
}
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