Elevated incidence of infant botulism in a 17-county area of the Mid-Atlantic region in the United States, 2000-2019, including association with soil types.

IF 3.9 2区 生物学 Q2 BIOTECHNOLOGY & APPLIED MICROBIOLOGY
Haydee A Dabritz, Ingrid K Friberg, Jessica R Payne, Camille Moreno-Gorrin, Kristy Lunquest, Deepam Thomas, Alexandra P Newman, Elizabeth A Negrón, Patrick J Drohan
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引用次数: 0

Abstract

We sought to identify counties in the northeastern United States where the incidence of infant botulism (IB) is elevated compared to the nationwide incidence and to assess associations with soil type at the case residence. IB cases were identified through the distribution of the orphan drug Human Botulism Immune Globulin Intravenous for treatment of IB by state and national surveillance systems and were subsequently confirmed by laboratory testing. IB incidence by county was calculated as the number of IB cases divided by the number of live births in the county from 2000 to 2019. Cases were spatially mapped and assigned to soil types using the US Department of Agriculture's online soils database. Possible association with soil type was evaluated with the Chi-squared test. We identified a rectangular area consisting of 17 contiguous counties in Delaware, Maryland, New Jersey, New York, and Pennsylvania, approximately 80 km by 250 km, in which the 20-year incidence of IB was nearly seven times greater than that of the remaining counties in those five states. Within this area, case residences were strongly associated with certain soil types (P ≤ 0.003). From 2000 to 2019, IB occurred with disproportionate incidence in a rectangular area encompassing the lower Delaware and Raritan River Valley and parts of five adjacent states. Further investigation of the soils in counties from this area could assess whether C. botulinum is more prevalent in certain soil types and whether isolation of C. botulinum is more common in counties with higher IB incidence.

Importance: Infant botulism occurs more frequently in 17 counties within and adjacent to the Delaware and Raritan River watersheds. This study should alert physicians and pediatricians in the area to the higher likelihood of encountering cases of this otherwise rare disease that manifests with constipation, poor feeding, loss of head control, weak suck/cry, generalized weakness, and descending bilateral paralysis.

2000-2019 年美国大西洋中部地区 17 个县的婴儿肉毒中毒发病率升高,包括与土壤类型的关系。
我们试图确定美国东北部婴儿肉毒中毒(IB)发病率高于全国发病率的县,并评估与病例居住地土壤类型的关系。IB病例是通过各州和国家监测系统分发用于治疗IB的孤儿药物人肉毒杆菌免疫球蛋白静脉注射剂而确定的,随后通过实验室检测加以确认。2000 年至 2019 年期间,各县 IB 发病率的计算方法是 IB 病例数除以该县活产婴儿数。使用美国农业部的在线土壤数据库对病例进行空间映射,并将其归入土壤类型。通过卡方检验(Chi-squared test)评估与土壤类型的可能关联。我们确定了一个矩形区域,该区域由特拉华州、马里兰州、新泽西州、纽约州和宾夕法尼亚州的 17 个毗连县组成,面积约为 80 千米乘 250 千米。在这一地区,病例居住地与某些土壤类型密切相关(P ≤ 0.003)。从 2000 年到 2019 年,IB 在特拉华州下游和拉里坦河谷以及邻近 5 个州部分地区的矩形区域内的发生率过高。对这一地区各县土壤的进一步调查可以评估肉毒杆菌是否在某些土壤类型中更为普遍,以及肉毒杆菌的分离是否在IB发病率较高的县更为常见:婴儿肉毒中毒在特拉华河和拉里坦河流域内和邻近的 17 个县发生得更频繁。这项研究应提醒该地区的医生和儿科医生,更有可能遇到这种原本罕见的疾病病例,其表现为便秘、喂养不良、头部失控、吸吮/哭声微弱、全身无力和双侧下肢瘫痪。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Applied and Environmental Microbiology
Applied and Environmental Microbiology 生物-生物工程与应用微生物
CiteScore
7.70
自引率
2.30%
发文量
730
审稿时长
1.9 months
期刊介绍: Applied and Environmental Microbiology (AEM) publishes papers that make significant contributions to (a) applied microbiology, including biotechnology, protein engineering, bioremediation, and food microbiology, (b) microbial ecology, including environmental, organismic, and genomic microbiology, and (c) interdisciplinary microbiology, including invertebrate microbiology, plant microbiology, aquatic microbiology, and geomicrobiology.
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