title: Salmonella Infection in Middle-Aged and Older Adults: Incidence and Risk Factors from the 45 and Up Study.
abstract: Salmonella infection is one of the most common foodborne bacterial pathogens, and causes a significant health burden globally. We investigated the incidence and risk factors for notification and hospitalization due to Salmonella infection in older adults.
  
  
  
  We used the 45 and Up Study, a large-scale Australian prospective study of adults aged ≥45 years, with record linkage to multiple databases for the years 2006-2012 to estimate the incidence of notification and hospitalization for Salmonella infection and estimate hazard ratios using Cox regression.
  
  
  
  Over a total follow-up of 1,120,242 person-years, 333 adults had laboratory-confirmed Salmonella infection and 101 were hospitalized; the notification and hospitalization incidence were 29.7 (95% confidence interval [CI]: 26.9-33.3) and 9.0 (95% CI: 7.4-10.9) per 100,000 person-years, respectively. The risk of Salmonella infection notification did not differ by age, but risk of hospitalization increased with age. Elderly males had the highest risk of infection-related hospitalization. The risk of notification was higher for those living in rural or remote areas (adjusted hazard ratio [aHR] 1.7, 95% CI 1.3-2.2), those taking proton pump inhibitors (aHR 1.9, 95% CI 1.4-2.4), and those reporting chicken/poultry intake at least seven times per week (aHR 3.2, 95% CI 1.3-7.9).
  
  
  
  Chicken consumption remains a significant risk factor for Salmonella infection, highlighting the importance of reducing contamination of poultry and improving food safety advice for older people.
authors.affiliation: 1 The Australian National University , Canberra, Australia .
authors.forename: Yingxi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: 1 The Australian National University , Canberra, Australia .
authors.forename: Kathryn
authors.initials: K
authors.lastname: Glass
authors.affiliation: 2 University of New South Wales , Sydney, New South Wales, Australia .
authors.forename: Bette
authors.initials: B
authors.lastname: Liu
authors.affiliation: 3 NSW Minister of Health , Sydney, New South Wales, Australia .
authors.forename: Kirsty
authors.initials: K
authors.lastname: Hope
authors.affiliation: 1 The Australian National University , Canberra, Australia .
authors.forename: Martyn
authors.initials: M
authors.lastname: Kirk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000818:Animals; D015331:Cohort Studies; D018563:Disease Notification; D005260:Female; D005500:Follow-Up Studies; D005506:Food Contamination; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008460:Meat / Q000009:adverse effects* / Q000382:microbiology; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011200:Poultry / Q000382:microbiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012423:Rural Health; D012478:Salmonella Food Poisoning / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D057566:Self Report; D012737:Sex Factors
keywords: Salmonella infection; hospitalization; older adults