Journal
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE
Volume 106, Issue 1, Pages 26-34Publisher
OXFORD UNIV PRESS
DOI: 10.1016/j.trstmh.2011.10.004
Keywords
Vietnam; Bloodstream infections; Salmonella Typhi; Antimicrobial resistance; HIV infection
Funding
- Wellcome Trust of Great Britain, Euston Road, London, United Kingdom
- US National Institute of Health
- OAK Foundation through Oxford University [OAKF9]
- MRC [G1100682, G1100684] Funding Source: UKRI
- Medical Research Council [G1100682, G1100684] Funding Source: researchfish
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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 66111 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. (C) 2011 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.
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