| 1. |
- Ahlm, Clas, et al.
(författare)
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Seroprevalence of Sindbis virus and associated risk factors in northern Sweden
- 2014
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Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 142:7, s. 1559-1565
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Tidskriftsartikel (refereegranskat)abstract
- Mosquito-borne Sindbis virus (SINV) cause disease characterized by rash, fever and arthritis which often leads to long-lasting arthralgia. To determine the seroprevalence of SINV and associated risk factors in northern Sweden, a randomly selected population aged between 25 and 74 years were invited to join the MONICA study. Serum from 1611 samples were analysed for specific IgG antibodies. Overall, 2·9% had IgG against SINV. More men (3·7%) than women (2·0%) were SINV seropositive (P = 0·047) and it was more common in subjects with a lower educational level (P = 0·013) and living in small, rural communities (P < 0·001). Seropositivity was associated with higher waist circumference (P = 0·1), elevated diastolic blood pressure (P = 0·037), and history of a previous stroke (P = 0·011). In a multiple logistic regression analysis, adjusting for known risk factors for stroke, seropositivity for SINV was an independent predictor of having had a stroke (odds ratio 4·3, 95% confidence interval 1·4–13·0,P = 0·011).
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| 2. |
- Andersson, T, et al.
(författare)
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Syndromic surveillance for local outbreak detection and awareness : evaluating outbreak signals of acute gastroenteritis in telephone triage, web-based queries and over-the-counter pharmacy sales
- 2014
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Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 142:2, s. 303-313
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Tidskriftsartikel (refereegranskat)abstract
- For the purpose of developing a national system for outbreak surveillance, local outbreak signals were compared in three sources of syndromic data - telephone triage of acute gastroenteritis, web queries about symptoms of gastrointestinal illness, and over-the-counter (OTC) pharmacy sales of antidiarrhoeal medication. The data sources were compared against nine known waterborne and foodborne outbreaks in Sweden in 2007-2011. Outbreak signals were identified for the four largest outbreaks in the telephone triage data and the two largest outbreaks in the data on OTC sales of antidiarrhoeal medication. No signals could be identified in the data on web queries. The signal magnitude for the fourth largest outbreak indicated a tenfold larger outbreak than officially reported, supporting the use of telephone triage data for situational awareness. For the two largest outbreaks, telephone triage data on adult diarrhoea provided outbreak signals at an early stage, weeks and months in advance, respectively, potentially serving the purpose of early event detection. In conclusion, telephone triage data provided the most promising source for surveillance of point-source outbreaks.
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| 3. |
- Aspán, Anna, et al.
(författare)
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Microarray-based detection of virulence genes in verotoxigenic Escherichia coli O157:H7 strains from Swedish cattle
- 2011
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 139, s. 1088-1096
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Tidskriftsartikel (refereegranskat)abstract
- Verotoxigenic Escherichia coli (VTEC) serotype O157:H7 strains from a Swedish cattle prevalence study (n=32), and livestock-derived strains linked to human disease (n=13), were characterized by microarray and PCR detection of virulence genes. The overall aim of the study was to investigate the distribution of known virulence determinants and determine which genes are linked to increased pathogenicity in humans. A core set of 18 genes or gene variants were found in all strains, while seven genes were variably present. This suggests that the majority of VTEC O157:H7 found in Swedish cattle carry a broad repertoire of virulence genes and should be considered potentially harmful to humans. A single virulence gene type was significantly associated with strains linked to human disease cases (P=0.012), but no genetic trait to explain the increased virulence of this genotype could be found.
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| 4. |
- Ayukekbong, James A., et al.
(författare)
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Monitoring of seasonality of norovirus and other enteric viruses in Cameroon by real-time PCR : an exploratory study
- 2014
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Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 142:7, s. 1393-1402
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Tidskriftsartikel (refereegranskat)abstract
- We studied the seasonal fluctuation of norovirus and other enteric viruses in Cameroon. Two hundred participants aged between 1 and 69 years were prospectively followed up. Each participant provided monthly faecal samples over a 12-month period. A total of 2484 samples were tested using multiplex real-time PCR assay for the detection of norovirus, rotavirus and enterovirus. The effect of weather variables and risk factors were analysed by Pearson correlation and bivariate analysis. Overall, enterovirus was the most commonly detected virus (216% of specimens), followed by norovirus (39%) and rotavirus (04%). Norovirus and enterovirus were detected throughout the year with a peak of norovirus detection at the beginning of the rainy season and a significant alternation of circulation of norovirus genogroups from one month to the next. Age <5 years and consumption of tap water were risk factors for norovirus infection. Better understanding of factors influencing transmission and seasonality may provide insights into the relationship between physical environment and risk of infection for these viruses.
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| 5. |
- Ayukekbong, James, et al.
(författare)
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Monitoring of seasonality of norovirus and other enteric viruses in Cameroon by real-time PCR: an exploratory study
- 2014
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Ingår i: Epidemiology and Infection. - : Cambridge University Press (CUP). - 0950-2688 .- 1469-4409. ; 142:7, s. 1393-1402
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Tidskriftsartikel (refereegranskat)abstract
- We studied the seasonal fluctuation of norovirus and other enteric viruses in Cameroon. Two hundred participants aged between 1 and 69 years were prospectively followed up. Each participant provided monthly faecal samples over a 12-month period. A total of 2484 samples were tested using multiplex real-time PCR assay for the detection of norovirus, rotavirus and enterovirus. The effect of weather variables and risk factors were analysed by Pearson correlation and bivariate analysis. Overall, enterovirus was the most commonly detected virus (216% of specimens), followed by norovirus (39%) and rotavirus (04%). Norovirus and enterovirus were detected throughout the year with a peak of norovirus detection at the beginning of the rainy season and a significant alternation of circulation of norovirus genogroups from one month to the next. Age <5 years and consumption of tap water were risk factors for norovirus infection. Better understanding of factors influencing transmission and seasonality may provide insights into the relationship between physical environment and risk of infection for these viruses.
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| 6. |
- Backhans, Annette, et al.
(författare)
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Occurrence of pathogenic Yersinia enterocolitica and Yersinia pseudotuberculosis in small wild rodents
- 2011
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 139, s. 1230-1238
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Tidskriftsartikel (refereegranskat)abstract
- Rodents are a potential source of pathogenic Yersinia enterocolitica and Y. pseudotuberculosis. In order to study this, 190 rodents were captured and sampled on seven pig farms (n = 110), five chicken farms (n = 55) and six other locations (n = 25) in Sweden. Pigs from three of the pig farms were also sampled (n = 60). Pathogenic Y. enterocolitica was detected by TaqMan PCR in about 5% of rodent samples and 18% of pig samples. Only rodents caught on pig farms tested positive for the pathogen. Y. enterocolitica bioserotype 4/O:3 strains isolated from the rodent and pig samples were compared by pulsed-field gel electrophoresis and revealed a high degree of similarity, which was confirmed by random amplified polymorphic DNA. Y. pseudotuberculosis was only detected in one rodent sample. Thus, rodents may be vectors for the transmission of pathogenic Y. enterocolitica to pigs, acting as carriers rather than a reservoir, and should therefore remain an important issue in hygiene control measures on farms.
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| 7. |
- Backhans, Annette, et al.
(författare)
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Occurrence of pathogens in wild rodents caught on Swedish pig and chicken farms
- 2013
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 141, s. 1885-1891
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Tidskriftsartikel (refereegranskat)abstract
- A total of 207 wild rodents were caught on nine pig farms, five chicken farms and five non-farm locations in Sweden and surveyed for a selection of bacteria, parasites and viruses. Lawsonia intracellularia and pathogenic Yersinia enterocolitica were only detected in rodents on pig farms (9% and 8% prevalence, respectively) which indicate that these agents are more likely to be transmitted to rodents from pigs or the environment on infected farms. Brachyspira hyodysenteriae (1%), Brachyspira intermedia (2%), Campylobacter jejuni (4%), Campylobacter upsaliensis (2%), leptospires (7%) and encephalomyocarditis virus (9%) were also detected from rodents not in contact with farm animals. Giardia and Cryptosporidium spp. were common, although no zoonotic types were verified, and Salmonella enterica was isolated from 1/11 mice on one farm but not detected by PCR from any of the rodents. Trichinella spp. and Toxoplasma gondii were not detected.
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| 8. |
- Earnest, A, et al.
(författare)
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Meteorological factors and El Niño Southern Oscillation are independently associated with dengue infections
- 2012
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 140:07, s. 1244-1251
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Tidskriftsartikel (refereegranskat)abstract
- Our objective was to determine the association between temperature, humidity, rainfall and dengue activity in Singapore, after taking into account lag periods as well as long-term climate variability such as the El Niño Southern Oscillation Index (SOI). We used a Poisson model which allowed for autocorrelation and overdispersion in the data. We found weekly mean temperature and mean relative humidity as well as SOI to be significantly and independently associated with dengue notifications. There was an interaction effect by periods of dengue outbreaks, but periods where El Niño was present did not moderate the relationship between humidity and temperature with dengue notifications. Our results help to understand the temporal trends of dengue in Singapore, and further reinforce the findings that meteorological factors are important in the epidemiology of dengue.
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| 9. |
- Karlsson, Diana
(författare)
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Probabilistic network modelling of the impact of penicillin consumption on spread of pneumococci
- 2011
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Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 139:9, s. 1351-1360
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Tidskriftsartikel (refereegranskat)abstract
- The worldwide increase of resistant S. pneumoniae is a growing clinical problem. In several countries, a more restrictive use of penicillin has been promoted in hope of slowing the rates of resistant pneumococci. However, the consequences of such an action on pneumococcal population dynamics are not fully understood. Thus, a network model was constructed to assess the impacts of penicillin consumption and between-strain competition on the spread of penicillin non-susceptible pneumococci. Model simulations suggest that the age distribution for carriage of penicillin non-susceptible pneumococci, in contrast to susceptible pneumococci, is affected by penicillin consumption. Furthermore, it appears extremely difficult to reduce the incidence of penicillin non-susceptible pneumococci by simply controlling penicillin consumption, assuming that reduced penicillin susceptibility does not confer a fitness cost for the organism. A more judicious use of penicillin together with control measures are in that case required to manage penicillin resistance in pneumococci.
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| 10. |
- Larsson, C., et al.
(författare)
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Epidemiology and estimated costs of a large waterborne outbreak of norovirus infection in Sweden
- 2014
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Ingår i: Epidemiology and Infection. - : Cambridge University Press (CUP). - 1469-4409 .- 0950-2688. ; 142:3, s. 592-600
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Tidskriftsartikel (refereegranskat)abstract
- A large outbreak of norovirus (NoV) gastroenteritis caused by contaminated municipal drinking water occurred in Lilla Edet, Sweden, 2008. Epidemiological investigations performed using a questionnaire survey showed an association between consumption of municipal drinking water and illness (odds ratio 4 center dot 73, 95% confidence interval 3 center dot 53-6 center dot 32), and a strong correlation between the risk of being sick and the number of glasses of municipal water consumed. Diverse NoV strains were detected in stool samples from patients, NoV genotype I strains predominating. Although NoVs were not detected in water samples, coliphages were identified as a marker of viral contamination. About 2400 (18 center dot 5%) of the 13000 inhabitants in Lilla Edet became ill. Costs associated with the outbreak were collected via a questionnaire survey given to organizations and municipalities involved in or affected by the outbreak. Total costs including sick leave, were estimated to be similar to 8700000 Swedish kronor (similar to euro0 center dot 87 million).
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| 11. |
- Liese, J. G., et al.
(författare)
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Incidence and clinical presentation of acute otitis media in children aged < 6 years in European medical practices
- 2014
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 142:8, s. 1778-1788
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Tidskriftsartikel (refereegranskat)abstract
- We conducted an epidemiological, observational cohort study to determine the incidence and complications of acute otitis media (AOM) in children aged <6 years. Data on physician-diagnosed AOM were collected from retrospective review of medical charts for the year preceding enrolment and then prospectively in the year following enrolment. The study included 5776 children in Germany, Italy, Spain, Sweden, and the UK. AOM incidence was 256/1000 person-years [95% confidence interval (CI) 243-270] in the prospective study period. Incidence was lowest in Italy (195, 95% CI 171-222) and highest in Spain (328, 95% CI 296-363). Complications were documented in < 1% of episodes. Spontaneous tympanic membrane perforation was documented in 7% of episodes. Both retrospective and prospective study results were similar and show the high incidence during childhood in these five European countries. Differences by country may reflect true differences and differences in social structure and diagnostic procedures.
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| 12. |
- Lopez-Valladares, Gloria, 1963-, et al.
(författare)
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Human isolates of Listeria monocytogenes in Sweden during half a century (1958-2010)
- 2014
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 142, s. 2251-2260
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Tidskriftsartikel (refereegranskat)abstract
- Isolates of Listeria monocytogenes (n=932) isolated in Sweden during 1958–2010 from human patients with invasive listeriosis were characterized by serotyping and pulsed-field gel electrophoresis (PFGE) (AscI). Of the 932 isolates, 183 different PFGE types were identified, of which 83 were each represented by only one isolate. In all, 483 serovar 1/2a isolates were distributed over 114 PFGE types; 90 serovar 1/2b isolates gave 32 PFGE types; 21 serovar 1/2c isolates gave nine PFGE types; three serovar 3b isolates gave one PFGE type; and, 335 serovar 4b isolates gave 31 PFGE types. During the 1980s in Sweden, several serovar 4b cases were associated with the consumption of European raw soft cheese. However, as cheese-production hygiene has improved, the number of 4b cases has decreased. Since 1996, serovar 1/2a has been the dominant L. monocytogenes serovar in human listeriosis in Sweden. Therefore, based on current serovars and PFGE types, an association between human cases of listeriosis and the consumption of vacuum-packed gravad and cold-smoked salmon is suggested.
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| 13. |
- Malmsten, Jonas, et al.
(författare)
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Temporal and spatial variation in Anaplasma phagocytophilum infection in Swedish moose (Alces alces)
- 2014
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 142, s. 1205-1213
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Tidskriftsartikel (refereegranskat)abstract
- The occurrence of Anaplasma phagocytophilum was investigated in spleen and serum samples from Swedish moose (Alces alces) in southern Sweden (island and mainland). Samples were analysed for presence of A. phagocytophilum DNA by real-time PCR (n=263), and for Anaplasma antibodies with ELISA serology (n=234). All serum samples had antibodies against A. phagocytophilum. The mean DNA-based prevalence was 26 center dot 3%, and significant (P<0 center dot 01) temporal, and spatial variation was found. Island moose had significantly (P<0 center dot 001) higher prevalence of A. phagocytophilum DNA than moose from the mainland areas. Two samples were sequenced to determine genetic variation in the 16S rRNA and groESL genes. Genetic sequence similarity with the human granulocytic anaplasmosis agent, equine granulocytic ehrlichiosis agent, and different wildlife-associated A. phagocytophilum variants were observed in the 16S rRNA and groESL genes. Our study shows that moose are exposed to A. phagocytophilum in Sweden, and represent a potential wildlife reservoir of the pathogen.
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| 14. |
- Massad, E, et al.
(författare)
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Dengue infections in non-immune travellers to Thailand
- 2013
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 141:2, s. 412-417
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Tidskriftsartikel (refereegranskat)abstract
- Dengue is the most frequent arboviral disease and is expanding geographically. Dengue is also increasingly being reported in travellers, in particular in travellers to Thailand. However, data to quantify the risk of travellers acquiring dengue when travelling to Thailand are lacking. Using mathematical modelling, we set out to estimate the risk of non-immune persons acquiring dengue when travelling to Thailand. The model is deterministic with stochastic parameters and assumes a Poisson distribution for the mosquitoes' biting rate and a Gamma distribution for the probability of acquiring dengue from an infected mosquito. From the force of infection we calculated the risk of dengue acquisition for travellers to Thailand arriving in a typical year (averaged over a 17-year period) in the high season of transmission. A traveller arriving in the high season of transmission and remaining for 7 days has a risk of acquiring dengue of 0.2% (95% CI 0.16-0.23), whereas the risk for travel of 15 and 30 days' duration is 0.46% (95% CI 0.41-0.50) and 0.81% (95% CI 0.76-0.87), respectively. Our data highlight that the risk of non-immune travellers acquiring dengue in Thailand is substantial. The incidence of 0.81% after a 1-month stay is similar to that reported in prospective seroconversion studies in Israeli travellers to Thailand, highlighting that our models are consistent with actual data. Risk estimates based on mathematical modelling offer more detailed information depending on various travel scenarios, and will help the travel medicine provider give better evidence-based advice for travellers to dengue-endemic countries.
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| 15. |
- Pringle, Märit, et al.
(författare)
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Characterization and epidemiological relationships of Spanish Brachyspira hyodysenteriae field isolates
- 2010
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 138, s. 76-85
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Tidskriftsartikel (refereegranskat)abstract
- This research aimed to describe the genetic and phenotypic diversity of 74 Spanish Brachyspira hyodysenteriae field isolates, to establish epidemiological relationships between the isolates and to confirm the presence of tiamulin-resistant isolates in Spain. For these purposes, we performed biochemical tests in combination with diagnostic PCR analysis for the identification of Brachyspira spp. and for detection of the smpA/smpB gene. We also used antimicrobial susceptibility tests, random amplified polymorphic DNA (RAPD) and a new pulsed-field gel electrophoresis (PFGE) protocol. The combination of RAPD and PFGE allowed the study of epidemiological relationships. Both indole-negative and tiamulin-resistant isolates of B. hyodysenteriae are reported in Spain for the first time. The genetic analyses indicated a relationship between these Spanish isolates and indole-negative isolates previously obtained from Germany and Belgium.
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| 16. |
- Sannö, Axel, et al.
(författare)
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Presence of Salmonella spp., Yersinia enterocolitica, Yersinia pseudotuberculosis and Escherichia coli O157:H7 in wild boars
- 2014
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 142, s. 2542-2547
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Tidskriftsartikel (refereegranskat)abstract
- The European wild boar populations are growing and spreading to new areas, which might constitute a threat to public health, since wild boar can harbour pathogens with the potential to cause serious illness in humans. Tonsils, ileocaecal lymph nodes and faecal samples were collected from 88 Swedish wild boars and analysed for the presence of the zoonotic pathogens Salmonella spp., Yersinia enterocolitica, Y. pseudotuberculosis and enterohaemorrhagic Escherichia coli O157:H7 (EHEC). A combination of cultivation and polymerase chain reaction (PCR) analysis was used and overall, 20% of sampled individuals tested positive for Y. enterocolitica, 20% for Y. pseudotuberculosis and 10% for Salmonella spp. A total of 41% of sampled individuals tested positive for one or more of these three pathogens. No EHEC were detected. Samples PCR-positive for Salmonella spp. were cultivated further and six isolates were obtained, belonging to Salmonella enterica subspecies enterica and subspecies diarizone. The pathogens were most commonly detected in tonsil samples.
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| 17. |
- Schönberg-Norio, Daniela, et al.
(författare)
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Patient-reported complications associated with Campylobacter jejuni infection
- 2010
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 138:7, s. 1004-1011
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to investigate the occurrence of complications, especially musculoskeletal symptoms, after sporadic Campylobacter jejuni enteritis of domestic origin in Finland. This multi-centre cross-sectional study was conducted during a seasonal peak in 2002. Questionnaires were sent to Campylobacter-positive patients, representing different geographical areas, 2 months after collection of positive stool samples. Medical records were viewed in several cases. Besides antimicrobial susceptibility testing C. jejuni isolates were serotyped. A total of 235 patients (58%) returned the questionnaire and 201 C. jejuni-positive patients were finally included in the study. Musculoskeletal symptoms associated with C. jejuni enteritis were frequent (39%); joint pain was most commonly reported (81%). The incidence of reactive arthritis was 4% and that of Achilles enthesopathy and/or heel pain was 9%. Stomach ache during enteritis was associated with the later development of joint pain. Antimicrobial treatment was common but did not prevent complications.
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| 18. |
- Silverlås, Charlotte, et al.
(författare)
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Cryptosporidium spp. in calves and cows from organic and conventional dairy herds
- 2013
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 141, s. 529-539
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Tidskriftsartikel (refereegranskat)abstract
- A cohort study was performed to investigate cryptosporidial prevalence and species distribution in 13 organic and 13 conventional dairy herds. Faecal samples were collected from 221 calves and 259 cows. Management routines were recorded at farm inspection and through a questionnaire. Samples were concentrated using sodium chloride flotation and cryptosporidial oocysts were detected by epifluorescence microscopy. Molecular analysis was used to determine species and subtypes. A multivariable model for factors associated with calves being Cryptosporidium spp. positive was built. Cryptosporidium spp.-positive animals were identified in all herds. Prevalences were similar in organic and conventional calves (44.7% vs. 52.3%), as well as in cows (3.1% vs. 3.8%), P>0.05. Cryptosporidium bovis, C. ryanae and C. parvum were identified. C. ryanae was identified in a calf younger than the described prepatent period. The multivariable model included four significant variables; calf age, cleanliness of bedding, cleaning routines for group pens and farmers' attitudes towards biosecurity.
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| 19. |
- Stark, Lisa, et al.
(författare)
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Prevalence and molecular epidemiology of Staphylococcus aureus in Swedish nursing homes-as revealed in the SHADES study dagger
- 2014
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Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 142:6, s. 1310-1316
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Tidskriftsartikel (refereegranskat)abstract
- Knowledge of carriage and population dynamics of Staphylococcus aureus is crucial for infection risk assessment and to reveal transmission patterns of strains. We report the prevalence and molecular epidemiology of S. aureus in elderly people (n=290) living in nursing homes in three cities in the south of Sweden. The overall carriage prevalence rate was 48% when results from nares (31%) and throat (34%) samples were combined. Common spa types were equally distributed but a frequent type, t160, was found only in one of the regions. Carriage of different spa types was detected in 23% of individuals and antimicrobial resistance rates were higher in S. aureus isolates from those carrying more than one spa type. Five of the 21 individuals who carried different spa types were colonized simultaneously with resistant and non-resistant strains. Seventeen per cent of the individuals carried S. aureus of the same spa type on all occasions. Methicillin resistance was not detected. In conclusion we found a high prevalence of S. aureus in this elderly population with a high rate of dual colonization with different spa types. We also found signs of institutional spread of one strain.
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| 20. |
- Widén, Frederik, et al.
(författare)
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Molecular epidemiology of hepatitis E virus in humans, pigs and wild boars in Sweden
- 2011
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 139, s. 361-371
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Tidskriftsartikel (refereegranskat)abstract
- Hepatitis E infections in humans are usually acquired in endemic countries in Asia or Africa. In Sweden 17 cases infected in Europe, between 1993 and 2009, were identified. All had clinical hepatitis E with unknown source of infection. Hepatitis E virus (HEV) was identified in faecal samples from 63 piglets in 12 pig farms in Sweden. HEV was also identified in blood from 13 out of 159 investigated Swedish wild boars from nine counties. Partial HEV genomes from humans, pigs and wild boars were sequenced and compared by phylogeny. The results showed close relatedness between HEY strains from piglets from the same farm and from wild boars from the same county. HEV strains from humans showed relatedness with strains from pigs and wild boars from the same county. This study showed that HEY strains form geographical clusters in the phylogenetic tree. The methods used in this study may thus be used for tracing the origin of an infecting strain. Furthermore, this study indicated that there are endemic sources of human HEY infections in Sweden.
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| 21. |
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| 22. |
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| 23. |
- Soes, L. M., et al.
(författare)
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Risk factors for Clostridium difficile infection in the community: a case-control study in patients in general practice, Denmark, 2009-2011
- 2014
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 142:7, s. 1437-1448
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Tidskriftsartikel (refereegranskat)abstract
- To identify risk factors for Clostridium difficile infection (CDI) in Danish patients consulting general practice with gastrointestinal symptoms, a prospective matched case-control study was performed; cases (N=259) had positive cultures for toxigenic C. difficile and controls (N=455) negative cultures. Data were analysed by conditional logistic regression. In patients aged 2 years (138 cases), hospitalization [odds ratio (OR) 84, 95% confidence interval (CI) 31-23], consumption of beef (OR 55, 95% CI 20-15), phenoxymethylpenicillin (OR 15, 95% CI 27-82), dicloxacillin (OR 27, 95% CI 36-211), and extended spectrum penicillins (OR 92, 95% CI 19-45) were associated with CDI. In patients aged <2 years none of these were associated with CDI, but in a subgroup analysis contact with animals was associated with CDI (OR 81, 95% CI 10-64). This study emphasizes narrow-spectrum penicillins, and suggests beef consumption, as risk factors for CDI in adults, and indicates a different epidemiology of CDI in infants.
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| 24. |
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