Overseas travel upped risk for non-typhoidal Salmonella hospitalizations

Koch K. BMC Infect Dis. 2011;doi:10.1186/1471-2334-11-277.

Researchers from Denmark have found that international travel significantly increased the risk for hospitalization with non-typhoidal Salmonella bacteremia, differing between age groups and travel destinations.

For the population-based cohort study, Kristoffer Koch, MD, of Aarhus University Hospital in Aalborg, Denmark, and colleagues aimed to assess the proportion, risk factors and outcomes of patients hospitalized with non-typhoidal Salmonella bacteremia and the association with traveling across three Danish counties between 1999 and 2008.

The researchers assessed the RR for acquiring travel-related Salmonella bacteremia per 100,000 Danish travelers, based on age and travel destination, and compared that with patients diagnosed with travel-associated Salmonella gastroenteritis. The length of hospital stay, number of extraintestinal focal infections and mortality were compared among patients with travel-related bacteremia vs. patients with domestically acquired bacteremia.

Of 311 hospitalized patients identified with non-typhoidal Salmonella bacteremia, 24.4% had a history of international travel. The risk was highest among those aged 15 to 24 years (0.8/100,000 travelers) and 65 years and older (1.2/100,000 travelers).

Bacteremia was most commonly associated with travel to sub-Saharan Africa (OR=18.4; 95% CI, 6.9-49.5), the Middle East (OR=10.6; 95% CI, 2.1-53.2) and Southeast Asia (OR=4.0; 96% CI, 2.2-7.5).

In addition, the researchers found that patients hospitalized with travel-associated bacteremia had better clinical outcomes vs. patients with domestically acquired bacteremia, including shorter length of hospital stay (8 vs. 11 days); less extraintestinal focal infections (five vs. 31 patients); and a lower risk for death within 30 days (RR=0.2; 95% CI, 0.1-0.7) and 90 days (RR=0.3; 95% CI, 0.1-0.7), according to the study.

“A healthy traveler effect was a plausible explanation for the observed differences in outcomes,” they wrote.

Disclosure: This study was in part funded by the North Denmark Region and the private foundation of Heinrich Kopp, which supports health care research.

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