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Risk factors of Streptococcus suis infection in Vietnam. A case-control study.

Nghia HD, Ho DT, Tu le TP, Le TP, Wolbers M, Thai CQ, Cao QT, Hoang NV, Nguyen VM, Nga TV, Tran VT, Thao le TP, Le TP, Phu NH, Nguyen HP, Chau TT, Tran TH, Sinh DX, Dinh XS, Diep TS, To SD, Hang HT, Hoang TT, Truong H, Campbell J, Chau NV, Nguyen VV, Chinh NT, Nguyen TC, Dung NV, Nguyen VD, Hoa NT, Ngo TH, Spratt BG, Hien TT, Tran TH, Farrar J, Schultsz C - PLoS ONE (2011)

Bottom Line: Little is known of the risk factors underlying the disease.S. suis specific DNA was detected in rectal and throat swabs of 6 patients and was cultured from 2 rectal samples, but was not detected in such samples of 1522 healthy individuals or patients without S. suis infection.These risk factors can be addressed in public health campaigns aimed at preventing S. suis infection.

View Article: PubMed Central - PubMed

Affiliation: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.

ABSTRACT

Background: Streptococcus suis infection, an emerging zoonosis, is an increasing public health problem across South East Asia and the most common cause of acute bacterial meningitis in adults in Vietnam. Little is known of the risk factors underlying the disease.

Methods and findings: A case-control study with appropriate hospital and matched community controls for each patient was conducted between May 2006 and June 2009. Potential risk factors were assessed using a standardized questionnaire and investigation of throat and rectal S. suis carriage in cases, controls and their pigs, using real-time PCR and culture of swab samples. We recruited 101 cases of S. suis meningitis, 303 hospital controls and 300 community controls. By multivariate analysis, risk factors identified for S. suis infection as compared to either control group included eating "high risk" dishes, including such dishes as undercooked pig blood and pig intestine (OR(1) = 2.22; 95%CI = [1.15-4.28] and OR(2) = 4.44; 95%CI = [2.15-9.15]), occupations related to pigs (OR(1) = 3.84; 95%CI = [1.32-11.11] and OR(2) = 5.52; 95%CI = [1.49-20.39]), and exposures to pigs or pork in the presence of skin injuries (OR(1) = 7.48; 95%CI = [1.97-28.44] and OR(2) = 15.96; 95%CI = [2.97-85.72]). S. suis specific DNA was detected in rectal and throat swabs of 6 patients and was cultured from 2 rectal samples, but was not detected in such samples of 1522 healthy individuals or patients without S. suis infection.

Conclusions: This case control study, the largest prospective epidemiological assessment of this disease, has identified the most important risk factors associated with S. suis bacterial meningitis to be eating 'high risk' dishes popular in parts of Asia, occupational exposure to pigs and pig products, and preparation of pork in the presence of skin lesions. These risk factors can be addressed in public health campaigns aimed at preventing S. suis infection.

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Related in: MedlinePlus

Flow diagram of recruitment of cases and controls.*Study nurses were unaware of case or control status of patients. ** Eligible households were defined as households in the same commune as a case.
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pone-0017604-g001: Flow diagram of recruitment of cases and controls.*Study nurses were unaware of case or control status of patients. ** Eligible households were defined as households in the same commune as a case.

Mentions: Consecutive patients admitted with signs and symptoms consistent with central nervous system (CNS) infection were eligible for the study (Table 1). When S. suis infection was confirmed, patients were included as cases. After inclusion of a patient as a case, the next three consecutive patients admitted to the ward who met the inclusion criteria were included as hospital controls. Three community controls, matched for age (within a 10 year age range), were randomly identified from a list of eligible households available at the health center in the community of residence of the case, by using random number tables (Figure 1). Written informed consent was obtained from all patients and controls or their care takers.


Risk factors of Streptococcus suis infection in Vietnam. A case-control study.

Nghia HD, Ho DT, Tu le TP, Le TP, Wolbers M, Thai CQ, Cao QT, Hoang NV, Nguyen VM, Nga TV, Tran VT, Thao le TP, Le TP, Phu NH, Nguyen HP, Chau TT, Tran TH, Sinh DX, Dinh XS, Diep TS, To SD, Hang HT, Hoang TT, Truong H, Campbell J, Chau NV, Nguyen VV, Chinh NT, Nguyen TC, Dung NV, Nguyen VD, Hoa NT, Ngo TH, Spratt BG, Hien TT, Tran TH, Farrar J, Schultsz C - PLoS ONE (2011)

Flow diagram of recruitment of cases and controls.*Study nurses were unaware of case or control status of patients. ** Eligible households were defined as households in the same commune as a case.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3050921&req=5

pone-0017604-g001: Flow diagram of recruitment of cases and controls.*Study nurses were unaware of case or control status of patients. ** Eligible households were defined as households in the same commune as a case.
Mentions: Consecutive patients admitted with signs and symptoms consistent with central nervous system (CNS) infection were eligible for the study (Table 1). When S. suis infection was confirmed, patients were included as cases. After inclusion of a patient as a case, the next three consecutive patients admitted to the ward who met the inclusion criteria were included as hospital controls. Three community controls, matched for age (within a 10 year age range), were randomly identified from a list of eligible households available at the health center in the community of residence of the case, by using random number tables (Figure 1). Written informed consent was obtained from all patients and controls or their care takers.

Bottom Line: Little is known of the risk factors underlying the disease.S. suis specific DNA was detected in rectal and throat swabs of 6 patients and was cultured from 2 rectal samples, but was not detected in such samples of 1522 healthy individuals or patients without S. suis infection.These risk factors can be addressed in public health campaigns aimed at preventing S. suis infection.

View Article: PubMed Central - PubMed

Affiliation: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.

ABSTRACT

Background: Streptococcus suis infection, an emerging zoonosis, is an increasing public health problem across South East Asia and the most common cause of acute bacterial meningitis in adults in Vietnam. Little is known of the risk factors underlying the disease.

Methods and findings: A case-control study with appropriate hospital and matched community controls for each patient was conducted between May 2006 and June 2009. Potential risk factors were assessed using a standardized questionnaire and investigation of throat and rectal S. suis carriage in cases, controls and their pigs, using real-time PCR and culture of swab samples. We recruited 101 cases of S. suis meningitis, 303 hospital controls and 300 community controls. By multivariate analysis, risk factors identified for S. suis infection as compared to either control group included eating "high risk" dishes, including such dishes as undercooked pig blood and pig intestine (OR(1) = 2.22; 95%CI = [1.15-4.28] and OR(2) = 4.44; 95%CI = [2.15-9.15]), occupations related to pigs (OR(1) = 3.84; 95%CI = [1.32-11.11] and OR(2) = 5.52; 95%CI = [1.49-20.39]), and exposures to pigs or pork in the presence of skin injuries (OR(1) = 7.48; 95%CI = [1.97-28.44] and OR(2) = 15.96; 95%CI = [2.97-85.72]). S. suis specific DNA was detected in rectal and throat swabs of 6 patients and was cultured from 2 rectal samples, but was not detected in such samples of 1522 healthy individuals or patients without S. suis infection.

Conclusions: This case control study, the largest prospective epidemiological assessment of this disease, has identified the most important risk factors associated with S. suis bacterial meningitis to be eating 'high risk' dishes popular in parts of Asia, occupational exposure to pigs and pig products, and preparation of pork in the presence of skin lesions. These risk factors can be addressed in public health campaigns aimed at preventing S. suis infection.

Show MeSH
Related in: MedlinePlus