Syndromic Gastrointestinal Panel Diagnostic Tests Have Changed our Understanding of the Epidemiology of Yersiniosis-Foodborne Diseases Active Surveillance Network, 2010-2021

Abstract

Background: In the US, yersinosis was understood to predominantly occur in winter and among Black or African American infants and Asian children. Increased use of culture-independent diagnostic tests (CIDTs) has led to marked increases in yersinosis diagnoses.

Methods: We describe differences in the epidemiology of yersiniosis diagnosed by CIDT versus culture in 10 US sites, and identify determinants of health associated with diagnostic method.

Results: Annual reported incidence increased from 0.3/100 000 in 2010 to 1.3/100 000 in 2021, particularly among adults ≥18 years, regardless of race and ethnicity, and during summer months. The proportion of CIDT-diagnosed infections increased from 3% in 2012 to 89% in 2021. An ill person's demographic characteristics and location of residence had a significant impact on their odds of being diagnosed by CIDT.

Conclusions: Improved detection due to increased CIDT use has altered our understanding of yersinosis epidemiology, however differential access to CIDTs may still affect our understanding of yersinosis.

Keywords: FoodNet; Foodborne Diseases Active Surveillance Network; Yersinia enterocolitica; culture-independent diagnostic tests; syndromic gastrointestinal panel tests.

Graphical abstract

Figure 1.

Number of infections and incidence rate of Yersinia enterocolitica* infections diagnosed by culture-based method (Cx) or culture-independent diagnostic tests (CIDT), by year-Foodborne Diseases Active Surveillance Network, 2010-2021. *There were 253 Cx detected infections reported from species other than Y. enterocolitica that were excluded from analyses: 94 frederiksenii, 67 intermedia, 33 pseudotuberculosis, 28 kristensenii, 17 ruckeri, 5 aldovae, 4 massiliensis, 1 aleksiciae, 1 rohdei.