Salmonella infections in Denmark from 2013-2022 with focus on serotype distribution, invasiveness, age, sex, and travel exposition

Eur J Clin Microbiol Infect Dis. 2024 May;43(5):947-957. doi: 10.1007/s10096-024-04808-9. Epub 2024 Mar 21.

Abstract

Purpose: To analyze the nationwide incidence of Salmonella infections in Denmark from 2013 to 2022.

Methods: Confirmed cases of Salmonella enterica subsp. enterica were examined using the National Register of Enteric Pathogens during 2013-2022. Proportions, incidence rates (IR), relative risk (RR), and 95% confidence intervals (CI) were calculated to assess differences in serotypes, invasiveness, age, sex, and travel exposure.

Results: We identified 9,944 Danish Salmonella enterica subsp. enterica cases, with an average annual incidence rate of 16.9 per 100,000 inhabitants, declining during the COVID-19 pandemic. Typhoidal cases totaled 206, with an average annual IR of 0.35 per 100,000 inhabitants. Enteric fever patients had a median age of 24 years (IQR:17-36). Leading non-typhoid Salmonella (NTS) serotypes were S. Enteritidis (26.4%), monophasic S. Typhimurium (16.5%), and S. Typhimurium (13.5%). Median age for NTS cases was 42 (IQR: 18-62), with even sex distribution, and a third reported travel prior to onset of disease. The overall percentage of invasive NTS (iNTS) infection was 8.1% (CI: 7.6-8.7). Eleven serotypes were associated with higher invasiveness, with S. Dublin and S. Panama having the highest invasiveness with age and sex-adjusted RR of 7.31 (CI: 6.35-8.43) and 5.42 (CI: 3.42-8.60), respectively, compared to all other NTS serotypes. Increased age was associated with higher RR for iNTS infection.

Conclusion: During the decade, there was a limited number of typhoidal cases. The dominant NTS serotypes were S. Enteritidis and monophasic S. Typhimurium, whereas S. Dublin and S. Panama exhibited the highest invasive potential.

Keywords: Salmonella; Invasiveness; Non-typhoid Salmonella (NTS); Salmonellosis; Typhoid Salmonella.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Child
  • Child, Preschool
  • Denmark / epidemiology
  • Female
  • Humans
  • Incidence
  • Infant
  • Male
  • Middle Aged
  • Salmonella / classification
  • Salmonella Infections* / epidemiology
  • Salmonella Infections* / microbiology
  • Serogroup*
  • Sex Factors
  • Travel* / statistics & numerical data
  • Young Adult

Supplementary concepts

  • Salmonella enterica subsp. enterica