Invasive non-Typhi Salmonella (NTS) is endemic in sub-Saharan Africa where it is a leading cause of bloodstream infection. Host risk factors have been established, but little is known about environmental reservoirs and predominant modes of transmission so prevention strategies are underdeveloped. While foodborne transmission from animals to humans predominates in high-income countries, it has been postulated that anthroponotic transmission both within and outside healthcare facilities may be important in sub-Saharan Africa. Antimicrobial resistance to ampicillin, trimethoprim-sulphamethoxazole and chloramphenicol is common; wider use of alternative agents may be warranted for empiric therapy. Vaccine development targeting the leading invasive NTS serotypes Typhimurium and Enteritidis shows promise. The clinical presentation of NTS bacteremia is non-specific and in the absence of blood culture may be confused with other febrile illnesses such as malaria. Much work remains to understand and control invasive NTS in sub-Saharan Africa.
【저자키워드】 HIV, Africa, Bacteremia, Salmonella infections, Salmonella enterica,