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Peter Gerner-Smidt

Publications and source records attributed to Peter Gerner-Smidt.

27 records · Page 2Linked to original sources
PubMed2004

Virulence factors for hemolytic uremic syndrome, Denmark.

We present an analysis of strain and patient factors associated with the development of bloody diarrhea and hemolytic uremic syndrome (HUS) among Shiga toxin-producing Escherichia coli (STEC) patients registered in Denmark in a 6-year period. Of 343 STEC patients, bloody diarrhea developed in 36.4% and HUS in 6.1%. In a multivariate logistic regression model, risk factors for bloody diarrhea were the eae and stx2 genes, O groups O157 and O103, and increasing age. Risk factors for HUS were presence of the stx2 (odds ratio [OR] 18.9) and eae (OR undefined) genes, being a child, and having bloody diarrhea. O group O157, although associated with HUS in a univariate analysis (OR 4.0), was not associated in the multivariate analysis (OR 1.1). This finding indicates that, rather than the O group, the combined presence of the eae and stx2 genes is an important predictor of HUS.

Adhesins, Bacterial↗
PubMed2003

Short and long term mortality associated with foodborne bacterial gastrointestinal infections: registry based study.

OBJECTIVES: To determine the excess mortality associated with infections with Salmonella, Campylobacter, Yersinia enterocolitica, and Shigella and to examine the effect of pre-existing illness. DESIGN: Registry based, matched cohort study. SETTING: Denmark. PARTICIPANTS: 48 857 people with gastrointestinal infections plus 487 138 controls from the general population. MAIN OUTCOME MEASURE: One year mortality among patients with gastrointestinal infections compared with controls after adjustment for comorbidity. RESULTS: 1071 (2.2%) people with gastrointestinal infections died within one year after infection compared with 3636 (0.7%) controls. The relative mortality within one year was 3.1 times higher in patients than in controls. The relative mortality within 30 days of infection was high in all four bacterial groups. Furthermore, there was excess mortality one to six months after infection with Yersinia enterocolitica (relative risk 2.53, 95% confidence interval 1.38 to 4.62) and from six months to one year after infection with Campylobacter (1.35, 1.02 to 1.80) and Salmonella (1.53, 1.31 to 1.79). CONCLUSIONS: Infections with all these bacteria were associated with an increased short term risk of death, even after pre-existing illnesses were taken into account. Salmonella, Campylobacter, and Yersinia enterocolitica infections were also associated with increased long term mortality.

Bacterial Infections↗
PubMed2003

[Excess mortality associated with antibiotic resistant Salmonella typhimurium].

INTRODUCTION: The use of antimicrobials in food production has been associated with drug-resistance in foodborne pathogens such as Salmonella and Campylobacter. However, little is known about the health impact of antimicrobial drug-resistance in these pathogens. In a matched cohort study, we determined the mortality associated with drug-resistance in Salmonella Typhimurium. MATERIAL AND METHODS: Data from the Danish Surveillance Registry for Enteric Pathogens were linked with the Civil Registration System and the Danish National Patient Registry. By survival analysis, the two-year mortality among patients was compared with a matched sample of the general Danish population adjusted for differences in comorbidity. RESULTS: Among 2047 cases of S. Typhimurium, 59 deaths were identified. Patients with pan-susceptible strains of S. Typhimurium were 2.3 times (95 per cent confidence interval [CI] 1.5-3.5) more likely to die in the two-year follow-up period after infection than persons in the general Danish population. Patients infected with strains resistant to ampicillin, chloramphenicol, streptomycin, sulfonamide, and tetracycline were 4.8 times (95 per cent CI 2.2-10.5) more likely to die, whereas quinolone-resistance was associated with a 10.3 times (95 percent CI 2.8-37.8) higher mortality than the general population. DISCUSSION: Overall, infections with S. Typhimurium were associated with excess mortality. Patients infected with multi-drug resistant strains had a tendency towards higher mortality than patients infected with non-multiresistant strains. Particular risk was associated with quinolone-resistance in foodborne S. Typhimurium, and the excess mortality among patients infected with multi-drug resistant S. Typhimurium could be attributed to additional quinolone resistance in many of the multi-drug resistant isolates.

4-Quinolones↗
PubMed2003

Salmonella control programs in Denmark.

We describe Salmonella control programs of broiler chickens, layer hens, and pigs in Denmark. Major reductions in the incidence of foodborne human salmonellosis have occurred by integrated control of farms and food processing plants. Disease control has been achieved by monitoring the herds and flocks, eliminating infected animals, and diversifying animals (animals and products are processed differently depending on Salmonella status) and animal food products according to the determined risk. In 2001, the Danish society saved U.S.$25.5 million by controlling Salmonella. The total annual Salmonella control costs in year 2001 were U.S.$14.1 million (U.S.$0.075/kg of pork and U.S.$0.02/kg of broiler or egg). These costs are paid almost exclusively by the industry. The control principles described are applicable to most industrialized countries with modern intensive farming systems.

Animals↗
PubMed2002

Excess mortality associated with antimicrobial drug-resistant Salmonella typhimurium.

In a matched cohort study, we determined the death rates associated with drug resistance in Salmonella Typhimurium. We linked data from the Danish Surveillance Registry for Enteric Pathogens with the Civil Registration System and the Danish National Discharge Registry. By survival analysis, the 2-year death rates were compared with a matched sample of the general Danish population, after the data were adjusted for differences in comorbidity. In 2,047 patients with S. Typhimurium, 59 deaths were identified. Patients with pansusceptible strains of S. Typhimurium were 2.3 times more likely to die 2 years after infection than persons in the general Danish population. Patients infected with strains resistant to ampicillin, chloramphenicol, streptomycin, sulfonamide, and tetracycline were 4.8 times (95% CI 2.2 to 10.2) more likely to die, whereas quinolone resistance was associated with a mortality rate 10.3 times higher than the general population.

Adolescent↗
PubMed2002

Increasing quinolone resistance in Salmonella enterica serotype Enteritidis.

Until recently, Salmonella enterica serotype Enteritidis has remained sensitive to most antibiotics. However, national surveillance data from Denmark show that quinolone resistance in S. Enteritidis has increased from 0.8% in 1995 to 8.5% in 2000. These data support concerns that the current use of quinolone in food animals leads to increasing resistance in S. Enteritidis and that action should be taken to limit such use.

Animals↗
PubMed1998

Water-borne Campylobacter jejuni infection in a Danish town---a 6-week continuous source outbreak.

OBJECTIVE: To determine the cause and characteristics of illness of a Campylobacter jejuni outbreak in Denmark in 1995--96. METHODS: A retrospective follow-up study was designed for culture-confirmed cases and for residents without a bacteriologic diagnosis. Stored clinical and environmental isolates were analyzed by serotyping and genotyping with restriction endonuclease analysis (REA), pulsed-field gel electrophoresis (PFGE) and ribotyping. RESULTS: Campylobacter jejuni was isolated from 110 residents and visitors to the area. However, an estimate based on a telephone survey indicated that some 2400 people were affected by the outbreak. Water samples obtained from the community waterworks contained Campylobacter jejuni serotype O2, the same serotype as in all but one of the 30 stored isolates from the outbreak. The water and clinical isolates also showed the same DNA profile, except for the single strain showing the distinct serotype. The contamination of the water supply was traced back to contamination of ground water due to a break in a sewage pipe. CONCLUSIONS: A retrospective and demographic epidemiologic investigation of both culture-confirmed and non-culture-confirmed cases in the town combined with typing of the isolates was crucial in defining the extent and cause of the outbreak.

Journal Article↗