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Background: It is well acknowledged that the use of antimicrobial drugs in food animals leads to antimicrobial drug resistance in foodborne bacteria such as Campylobacter; however, the role of human antimicrobial usage is much less investigated. The aim of this study was to quantify the odds of campylobacteriosis conferred by human consumption of fluoroquinolones and macrolides., Methods: We conducted a registry-based retrospective case-control study on 31 669 laboratory-confirmed cases of campylobacteriosis between 1999 and 2005 in Denmark. Data were obtained from several Danish databases: the National Registry of Enteric Pathogens, the Danish Civil Registration System, the Danish National Prescription Database, and the Integrated Database on Labor Market Research. Odds ratios (OR) for campylobacteriosis were calculated by conditional logistic regression., Results: The risk of campylobacteriosis was reduced 1 month after exposure to macrolides (OR, 0.72; 95% confidence interval [CI], 0.56-0.92). Macrolide exposure 1 month to 2 years before infection was associated with an increased risk of a Campylobacter diagnosis (OR, 1.5; 95% CI, 1.4-1.6). A history of fluoroquinolone use was also associated with increased risk (OR, 2.5; 95% CI, 1.8-3.5). This risk was higher for resistant isolates than for susceptible ones., Conclusions: Treatment with macrolides may protect against Campylobacter infection for a limited period of time, possibly due to the antibacterial effects of the drug or its metabolites. Fluoroquinolone treatment confers increased risk, probably due to a combination of competitive and selective effects, similar to what has been observed for nontyphoid Salmonella infection.

Objectives: The use of antimicrobial drugs for food animals selects for resistant non-typhoid Salmonella strains, but human consumption of antimicrobial drugs may also increase the risk of subsequent infection. The aim of this study was to determine the risk of salmonellosis attributable to human consumption of antimicrobial drugs in a case-control study of 22 602 laboratory-confirmed Salmonella infections, diagnosed in Denmark between 1997 and 2005., Methods: A population registry-based case-control study, using several Danish databases: the National Prescription Database; the National Registry for Enteric Pathogens; the Civil Registry System; and the Integrated Database on Labour Market Research., Results: Exposure to trimethoprim, sulphonamides, broad-spectrum penicillins, tetracyclines and fluoroquinolones, during the year prior to diagnosis, was associated with an increased risk of non-typhoid Salmonella infection. Overall, the highest risk was associated with the prior use of fluoroquinolones. This risk increased as the time window of exposure approached the infection date. Previous use of fluoroquinolones was associated with an odds ratio (OR) of 4.55 [95% confidence interval (CI): 3.78-5.47] for Salmonella serotypes other than Salmonella Typhimurium or Salmonella Enteritidis, an OR of 2.21 (95% CI: 1.70-2.86) for Salmonella Typhimurium and an OR of 2.07 (95% CI: 1.76-2.42) for Salmonella Enteritidis. In particular for fluoroquinolones, there was an interaction between the pathogen resistance pattern and a history of antibiotic drug use., Conclusions: The increasing use of antibiotics, particularly fluoroquinolones, is likely to result in increased incidence of foodborne infections with drug-resistant Salmonella.

Background: Previous research has reported that greater intelligence in early life is associated with longer lifespan. Whether this relationship is mediated by genetic factors or environmental factors, some of which could be modified by an individual, is unclear., Objective: We examined the association between intelligence test scores, obtained during the 1940s, and age at death in a group of 492 male twin pairs, members of the National Academy of Sciences--National Research Council Twins Registry of WWII veterans., Design: Using self-report information collected in th 1960s, we examined whether modifiable risk factors for mortality, such as use of tobacco and alcohol, cardiovascular disease, and body mass index altered the association between intelligence and longevity., Results: When each member of a twin pair was treated as an independent observation, higher intelligence test scores were associated with longer life span (P = 0.0002). Modifiable risk factors were associated with life span as expected. However, in co-twin control analyses in which one twin served as the control for the other twin, neither intelligence nor any modifiable risk factors showed a significant association with life span., Conclusion: Our findings suggest that genetics and early life environmental factors contribute heavily to lifespan and when one controls for these factors using twins, the effect of intelligence on longevity is diminished.

Background: Foodborne bacterial gastrointestinal infections are important causes of morbidity and mortality worldwide, and despite successful control programs in some developed countries, these infections continue to have a major impact on public health and economy., Methods: On the basis of data from 3 national registries, we determined short- and long-term risks of hospitalization due to gastroenteritis, short-term complications, and long-term sequelae after infections with nontyphoid Salmonella enterica, Campylobacter species, Yersinia enterocolitica, diarrheagenic Escherichia coli, and Shigella species., Results: Among 52,121 patients, 7524 (14.4%) were hospitalized with a diagnosis of gastroenteritis within 90 days after microbiological diagnosis. A total of 4941 patients (17.7%) with infections due to S. enterica and 1937 (10.8%) with infections due to Campylobacter species were admitted to the hospital. Complications, such as gastrointestinal perforation and invasive illness, occurred in 647 patients (1.2%). The risk of invasive illness was > 6-fold higher in patients with infections due to S. enterica (odds ratio [OR] compared with the general population, 30.3; 95% confidence interval [CI], 26.2-35.1) than in those with infections due to Campylobacter species (OR, 4.9; 95% CI, 3.5-6.8) (P < .001). Long-term sequelae were seen in 865 patients (1.7%). Among 1000 patients with infections due to S. enterica, 1820 days of hospital stay were attributable to gastroenteritis, complications, and long-term sequelae. The corresponding figure for Campylobacter infections was 714 days., Conclusions: Infections with bacteria that are usually foodborne cause considerable morbidity, in terms of severe gastroenteritis that requires admission to hospital, as well as complications and long-term sequelae. The risk of complications and sequelae depends on bacterial species, and nontyphoid Salmonella is particularly associated with a burden of severe morbidity.

Background: Resistance to clinically important antimicrobial agents, particularly fluoroquinolones and macrolides, is increasing among Campylobacter isolates, but few studies have explored the human health consequences of such resistance., Methods: In a registry-based cohort study, we determined the risk of invasive illness and death associated with infection with quinolone- and erythromycin-resistant Campylobacter strains, while adjusting for comorbidity. We linked data from the Danish Surveillance Registry for Enteric Pathogens with data from the Civil Registration System and National Health Registries., Results: Of 3471 patients with Campylobacter infection, 22 (0.63%) had an adverse event, defined as invasive illness or death, within 90 days of the date of receipt of samples. Patients infected with quinolone-resistant Campylobacter strains had a 6-fold increased risk of an adverse event within 30 days of the date of receipt of samples, compared with patients infected with quinolone- and erythromycin-susceptible Campylobacter strains (adjusted odds ratio [AOR], 6.17 [95% confidence interval {CI}, 1.62-23.47]). However, infection with erythromycin-resistant strains was associated with a >5-fold risk of an adverse event within 90 days of the date of receipt of samples (AOR, 5.51 [95% CI, 1.19-25.50])., Conclusions: The present study provides evidence of the human health consequences of resistance to clinically important agents among Campylobacter infections and the need for increased efforts to mitigate such resistance.

In a registry-based cohort study, we determined the risk of invasive illness or death associated with infection with quinolone-resistant Salmonella serotype Typhimurium. We linked data from the Danish surveillance registry of enteric pathogens with data from the Danish civil registration system and 2 national health registries. Of 1323 patients infected with Salmonella Typhimurium, 46 (3.5%) were hospitalized due an invasive illness within 90 days of infection, and 16 (1.2%) died within 90 days of infection. After adjustment for age, sex, and comorbidity, infection with quinolone-resistant Salmonella Typhimurium was associated with a 3.15-fold (95% confidence interval, 1.39-7.10-fold) higher risk of invasive illness or death within 90 days of infection, compared with that observed for infection with pansusceptible strains.

We assessed the construct validity of several self-report measures and an interview-based measure of hostility (Interpersonal Hostility Assessment Technique [IHAT]) by evaluating their associations with a behavioral indicator of hostile emotions (facial expressions during social interaction). Participants in the study were 123 volunteers (44% males and 56% females) who were recruited from local community organizations. Self-report measures (Cook-Medley Hostility Scale, Rotter Interpersonal Trust Scale, Buss-Durkee Hostility Inventory, and Spielberger Anger Expression Scale) were represented by factor scores reflecting Overt Hostility, Covert Hostility, and Hostile Beliefs. A canonical correlation analysis identified significant associations between a set of facial affect scores reflecting animosity and various measures of hostility. Specifically, increases in anger and disgust expressions and decreases in happy facial expressions were associated with high IHAT scores and high scores on self-report measures of Hostile Beliefs and Covert Hostility. Women were more expressive than men, especially concerning positive affect, and women had lower scores on self-report measures of Hostile Beliefs and Overt Hostility. IHAT scores were uncorrelated with any of the self-report factors which suggests the two assessment techniques are tapping different aspects of the hostility construct.

Linear logistic analysis of the relationship of cardiovascular disease risk factors to an overall measure of health effect, ten-year mortality, revealed significant associations of death with systolic blood pressure, age, sex, diabetes mellitus, smoking, cholesterol, obesity (Quetelet index), race and social index. Attributable risk and population attributable risk estimates were derived from the model by changing actual variable values to target values. The results confirmed systolic hypertension and smoking as major public health problems and diabetes mellitus as a powerful risk factor for death. The small detrimental effect of cholesterol on probability of death limits the potential for an overall beneficial effect of preventive intervention. In fact, drug intervention in two reported trials of cholesterol reduction had negative overall effects. Demonstration of the association of a characteristic with a specific disease state does not alone justify attempts to eliminate the high risk state from a population. An overall detrimental health effect must be documented by suitable studies before trials of preventive intervention are undertaken or recommendations made to the public.