title: Increased burden of illness associated with antimicrobial-resistant Salmonella enterica serotype typhimurium infections.
abstract: This study investigated the burden of illness associated with 440 cases of Salmonella enterica serotype Typhimurium infection identified in Canada between December 1999 and November 2000. We categorized case subjects' infections by definitive phage type 104 (DT104) and antimicrobial-resistance patterns. These variables were then investigated as risk factors for hospitalization. Hospitalization was more likely to occur among case subjects whose infections were resistant to at least ampicillin, chloramphenicol and/or kanamycin, streptomycin, sulphamethoxazole, and tetracycline (R-type AK/CSSuT; odds ratio [OR], 2.3; P=.003), compared with case subjects with AK/CSSuT-susceptible infections, and among case subjects with non-DT104 R-type AKSSuT infections (OR, 3.6; P=.005), compared with case subjects with non-DT104 AKSSuT-susceptible infections. In contrast, hospitalization rates did not differ between case subjects with DT104 infections and case subjects with non-DT104 infections or between case subjects with DT104 R-type ACSSuT infections and case subjects with DT104 ACSSuT-susceptible infections. We estimated that 57% of the hospitalizations among AK/CSSuT case subjects and 72% of the hospitalizations among non-DT104 AKSSuT case subjects were attributable to the resistance patterns of the infections.
authors.affiliation: Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada. leah_martin@hc-sc.gc.ca
authors.forename: Leah J
authors.initials: LJ
authors.lastname: Martin
authors.forename: Murray
authors.initials: M
authors.lastname: Fyfe
authors.forename: Kathryn
authors.initials: K
authors.lastname: Doré
authors.forename: Jane A
authors.initials: JA
authors.lastname: Buxton
authors.forename: Franklin
authors.initials: F
authors.lastname: Pollari
authors.forename: Bonnie
authors.initials: B
authors.lastname: Henry
authors.forename: Dean
authors.initials: D
authors.lastname: Middleton
authors.forename: Rafiq
authors.initials: R
authors.lastname: Ahmed
authors.forename: Frances
authors.initials: F
authors.lastname: Jamieson
authors.forename: Bruce
authors.initials: B
authors.lastname: Ciebin
authors.forename: Scott A
authors.initials: SA
authors.lastname: McEwen
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D024881:Drug Resistance, Bacterial; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012480:Salmonella Infections / Q000191:economics* / Q000453:epidemiology; D012483:Salmonella Phages / Q000302:isolation & purification; D012486:Salmonella typhimurium / Q000145:classification / Q000187:drug effects* / Q000821:virology
chemical_list: D000900:Anti-Bacterial Agents