Volume 88, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Data on non-typhoidal (NTS) infection in South Asia are limited. We used data gathered prospectively from 1996 to 2011 as part of a hospital surveillance system in Dhaka, Bangladesh, to identify diarrheal patients with NTS isolated from stool. NTS was isolated in 1.3% (468 of 37,439) of diarrheal patients; 47% of total cases of NTS were in children < 5 years of age, although older adults (≥ 60 years) had the highest isolation rates. NTS isolation peaked in the monsoon months of July and August. Over the study period, rates of multidrug resistance decreased, whereas rates of decreased susceptibility to ciprofloxacin increased. Compared with control patients, NTS patients were older and wealthier; however, no differences in type of housing or exposure to animals were found. NTS patients had increased inflammatory cells in stool and required more fluid resuscitation.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Majowicz SE, Musto J, Scallan E, Angulo FJ, Kirk M, O'Brien SJ, Jones TF, Fazil A, Hoekstra RM, International Collaboration on Enteric Disease ‘Burden of Illness’ Studies; , 2010. The global burden of nontyphoidal Salmonella gastroenteritis. Clin Infect Dis 50: 882889.[Crossref] [Google Scholar]
  2. Feasey NA, Dougan G, Kingsley RA, Heyderman RS, Gordon MA, , 2012. Invasive non-typhoidal Salmonella disease: an emerging and neglected tropical disease in Africa. Lancet 379: 24892499.[Crossref] [Google Scholar]
  3. Ekdahl K, de Jong B, Wollin R, Andersson Y, , 2005. Travel-associated non-typhoidal salmonellosis: geographical and seasonal differences and serotype distribution. Clin Microbiol Infect 11: 138144.[Crossref] [Google Scholar]
  4. Menezes GA, Khan MA, Harish BN, Parija SC, Goessens W, Vidyalakshmi K, Baliga S, Hays JP, , 2010. Molecular characterization of antimicrobial resistance in non-typhoidal salmonellae associated with systemic manifestations from India. J Med Microbiol 59: 14771483.[Crossref] [Google Scholar]
  5. Jabeen K, Zafar A, Irfan S, Khan E, Mehraj V, Hasan R, , 2010. Increase in isolation of extended spectrum beta lactamase producing multidrug resistant non typhoidal salmonellae in Pakistan. BMC Infect Dis 10: 101.[Crossref] [Google Scholar]
  6. Kumar Y, Sharma A, Sehgal R, Kumar S, , 2009. Distribution trends of Salmonella serovars in India (2001–2005). Trans R Soc Trop Med Hyg 103: 390394.[Crossref] [Google Scholar]
  7. UNAIDS, 2010. Global Report: UNAIDS Report on the Global AIDS Epidemic 2010. Geneva: UNAIDS (Joint United Nations Programme on HIV/AIDS). [Google Scholar]
  8. Stoll BJ, Glass RI, Huq MI, Khan MU, Holt JE, Banu H, , 1982. Surveillance of patients attending a diarrhoeal disease hospital in Bangladesh. Br Med J (Clin Res Ed) 285: 11851188.[Crossref] [Google Scholar]
  9. Holm S, , 1979. A simple sequentially rejective multiple test procedure. Scand J Stat 6: 6570. [Google Scholar]
  10. Lal A, Hales S, French N, Baker MG, , 2012. Seasonality in human zoonotic enteric diseases: a systematic review. PLoS One 7: e31883.[Crossref] [Google Scholar]
  11. Chen PL, Li CY, Hsieh TH, Chang CM, Lee HC, Lee NY, Wu CJ, Lee CC, Shih HI, Ko WC, , 2012. Epidemiology, disease spectrum and economic burden of non-typhoidal Salmonella infections in Taiwan, 2006–2008. Epidemiol Infect 140: 22562263.[Crossref] [Google Scholar]
  12. Hendriksen RS, Bangtrakulnonth A, Pulsrikarn C, Pornruangwong S, Noppornphan G, Emborg HD, Aarestrup FM, , 2009. Risk factors and epidemiology of the ten most common Salmonella serovars from patients in Thailand: 2002–2007. Foodborne Pathog Dis 6: 10091019.[Crossref] [Google Scholar]
  13. Gordon MA, Graham SM, Walsh AL, Wilson L, Phiri A, Molyneux E, Zijlstra EE, Heyderman RS, Hart CA, Molyneux ME, , 2008. Epidemics of invasive Salmonella enterica serovar enteritidis and S. enterica serovar typhimurium infection associated with multidrug resistance among adults and children in Malawi. Clin Infect Dis 46: 963969.[Crossref] [Google Scholar]
  14. Kariuki S, Revathi G, Kariuki N, Kiiru J, Mwituria J, Muyodi J, Githinji JW, Kagendo D, Munyalo A, Hart CA, , 2006. Invasive multidrug-resistant non-typhoidal Salmonella infections in Africa: zoonotic or anthroponotic transmission? J Med Microbiol 55: 585591.[Crossref] [Google Scholar]
  15. Brent AJ, Oundo JO, Mwangi I, Ochola L, Lowe B, Berkley JA, , 2006. Salmonella bacteremia in Kenyan children. Pediatr Infect Dis J 25: 230236.[Crossref] [Google Scholar]
  16. Koelle K, Rodo X, Pascual M, Yunus M, Mostafa G, , 2005. Refractory periods and climate forcing in cholera dynamics. Nature 436: 696700.[Crossref] [Google Scholar]
  17. Hashizume M, Armstrong B, Wagatsuma Y, Faruque AS, Hayashi T, Sack DA, , 2008. Rotavirus infections and climate variability in Dhaka, Bangladesh: a time-series analysis. Epidemiol Infect 136: 12811289.[Crossref] [Google Scholar]
  18. Brooks JT, Ochieng JB, Kumar L, Okoth G, Shapiro RL, Wells JG, Bird M, Bopp C, Chege W, Beatty ME, Chiller T, Vulule JM, Mintz E, Slutsker L, , 2006. Surveillance for bacterial diarrhea and antimicrobial resistance in rural western Kenya, 1997–2003. Clin Infect Dis 43: 393401.[Crossref] [Google Scholar]
  19. Reddy EA, Shaw AV, Crump JA, , 2010. Community-acquired bloodstream infections in Africa: a systematic review and meta-analysis. Lancet Infect Dis 10: 417432.[Crossref] [Google Scholar]
  20. Kariuki S, Revathi G, Kariuki N, Kiiru J, Mwituria J, Hart CA, , 2006. Characterisation of community acquired non-typhoidal Salmonella from bacteraemia and diarrhoeal infections in children admitted to hospital in Nairobi, Kenya. BMC Microbiol 6: 101.[Crossref] [Google Scholar]
  21. Feasey NA, Archer BN, Heyderman RS, Sooka A, Dennis B, Gordon MA, Keddy KH, , 2010. Typhoid fever and invasive nontyphoid salmonellosis, Malawi and South Africa. Emerg Infect Dis 16: 14481451.[Crossref] [Google Scholar]
  22. Hohmann EL, , 2001. Nontyphoidal salmonellosis. Clin Infect Dis 32: 263269.[Crossref] [Google Scholar]
  23. Gradel KO, Schonheyder HC, Dethlefsen C, Kristensen B, Ejlertsen T, Nielsen H, , 2008. Morbidity and mortality of elderly patients with zoonotic Salmonella and Campylobacter: a population-based study. J Infect 57: 214222.[Crossref] [Google Scholar]
  24. Kennedy M, Villar R, Vugia DJ, Rabatsky-Ehr T, Farley MM, Pass M, Smith K, Smith P, Cieslak PR, Imhoff B, Griffin PM, Emerging Infections Program FoodNet Working Group; , 2004. Hospitalizations and deaths due to Salmonella infections, FoodNet, 1996–1999. Clin Infect Dis 38 (Suppl 3): S142S148.[Crossref] [Google Scholar]
  25. Chuang CH, Su LH, Perera J, Carlos C, Tan BH, Kumarasinghe G, So T, VAN PH, Chongthaleong A, Hsueh PR, Liu JW, Song JH, Chiu CH, , 2009. Surveillance of antimicrobial resistance of Salmonella enterica serotype typhi in seven Asian countries. Epidemiol Infect 137: 266269.[Crossref] [Google Scholar]
  26. Holt KE, Dutta S, Manna B, Bhattacharya SK, Bhaduri B, Pickard DJ, Ochiai RL, Ali M, Clemens JD, Dougan G, , 2012. High-resolution genotyping of the endemic Salmonella typhi population during a Vi (typhoid) vaccination trial in Kolkata. PLoS Negl Trop Dis 6: e1490.[Crossref] [Google Scholar]
  27. Kundu R, Ganguly N, Ghosh TK, Yewale VN, Shah RC, Shah NK, IAP Task Force; , 2006. IAP task force report: management of enteric fever in children. Indian Pediatr 43: 884887. [Google Scholar]
  28. Nataro JP, Mai V, Johnson J, Blackwelder WC, Heimer R, Tirrell S, Edberg SC, Braden CR, Glenn Morris J, Jr Hirshon JM, , 2006. Diarrheagenic Escherichia coli infection in Baltimore, Maryland, and New Haven, Connecticut. Clin Infect Dis 43: 402407.[Crossref] [Google Scholar]
  29. Al Jarousha AM, El Jarou MA, El Qouqa IA, , 2011. Bacterial enteropathogens and risk factors associated with childhood diarrhea. Indian J Pediatr 78: 165170.[Crossref] [Google Scholar]
  30. Olesen B, Neimann J, Bottiger B, Ethelberg S, Schiellerup P, Jensen C, Helms M, Scheutz F, Olsen KE, Krogfelt K, Petersen E, Molbak K, Gerner-Smidt P, , 2005. Etiology of diarrhea in young children in denmark: a case-control study. J Clin Microbiol 43: 36363641.[Crossref] [Google Scholar]
  31. Moreno AC, Filho AF, Gomes T do A, Ramos ST, Montemor LP, Tavares VC, Filho L dos S, Irino K, Martinez MB, , 2010. Etiology of childhood diarrhea in the northeast of Brazil: significant emergent diarrheal pathogens. Diagn Microbiol Infect Dis 66: 5057.[Crossref] [Google Scholar]
  32. Bodhidatta L, McDaniel P, Sornsakrin S, Srijan A, Serichantalergs O, Mason CJ, , 2010. Case-control study of diarrheal disease etiology in a remote rural area in western Thailand. Am J Trop Med Hyg 83: 11061109.[Crossref] [Google Scholar]
  33. Albert MJ, Faruque AS, Faruque SM, Sack RB, Mahalanabis D, , 1999. Case-control study of enteropathogens associated with childhood diarrhea in Dhaka, Bangladesh. J Clin Microbiol 37: 34583464. [Google Scholar]
  34. Lindsay B, Ramamurthy T, Sen Gupta S, Takeda Y, Rajendran K, Nair GB, Stine OC, , 2011. Diarrheagenic pathogens in polymicrobial infections. Emerg Infect Dis 17: 606611.[Crossref] [Google Scholar]
  35. Hale CR, Scallan E, Cronquist AB, Dunn J, Smith K, Robinson T, Lathrop S, Tobin-D'Angelo M, Clogher P, , 2012. Estimates of enteric illness attributable to contact with animals and their environments in the United States. Clin Infect Dis 54 (Suppl 5): S472S479.[Crossref] [Google Scholar]
  36. Dione MM, Ikumapayi UN, Saha D, Mohammed NI, Geerts S, Ieven M, Adegbola RA, Antonio M, , 2011. Clonal differences between non-typhoidal Salmonella (NTS) recovered from children and animals living in close contact in the gambia. PLoS Negl Trop Dis 5: e1148.[Crossref] [Google Scholar]
  37. Khan MI, Ochiai RL, von Seidlein L, Dong B, Bhattacharya SK, Agtini MD, Bhutta ZA, Do GC, Ali M, Kim DR, Favorov M, Clemens JD, , 2010. Non-typhoidal Salmonella rates in febrile children at sites in five Asian countries. Trop Med Int Health 15: 960963.[Crossref] [Google Scholar]
  38. Nga TV, Parry CM, Le T, Lan NP, Diep TS, Campbell JI, Hoang NV, Dung le T, Wain J, Dolecek C, Farrar JJ, Chau NV, Hien TT, Day JN, Baker S, , 2012. The decline of typhoid and the rise of non-typhoid salmonellae and fungal infections in a changing HIV landscape: bloodstream infection trends over 15 years in southern vietnam. Trans R Soc Trop Med Hyg 106: 2634.[Crossref] [Google Scholar]
  39. Kiratisin P, , 2008. Bacteraemia due to non-typhoidal Salmonella in Thailand: clinical and microbiological analysis. Trans R Soc Trop Med Hyg 102: 384388.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 01 Nov 2012
  • Accepted : 21 Dec 2012
  • Published online : 03 Apr 2013

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error