Non-typhoidal Salmonella Gastroenteritis in Childhood: Clinical Features and Antibiotics Resistance.
- Author:
So Young NA
1
;
Byung Chan KIM
;
Hye Ran YANG
;
Soo Jin JUNG
;
Kyung Hoon LEE
;
Jae Sung KO
;
Hoan Jong LEE
;
Eui Chong KIM
;
Jeong Kee SE
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Non-typhoidal salmonella gastroenteritis;
Antibiotics resistance
- MeSH:
Ampicillin;
Anti-Bacterial Agents*;
Cefixime;
Cefotaxime;
Child;
Chloramphenicol;
Ciprofloxacin;
Drug Resistance, Microbial;
Drug Resistance, Multiple;
Drug Therapy;
Female;
Gastroenteritis*;
Humans;
Immunocompromised Host;
Incidence;
Male;
Prevalence;
Salmonella*;
Sulfamethoxazole;
Trimethoprim, Sulfamethoxazole Drug Combination
- From:Korean Journal of Pediatric Gastroenterology and Nutrition
2002;5(2):150-157
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: As the incidence of non-typhoidal salmonella strains resistant to antibiotics has been increased, we attempted to investigate clinical aspects of non-typhoidal salmonella gastroenteritis and antibiotics resistance. METHODS: From January 2000 to June 2002, 99 children with positive stool culture of non-typhoidal salmonella were studied about clinical features, the incidence of antibiotics and multi-drug resistance and the difference of incidence of antibiotics resistance according to immune status. RESULTS: There were 66 males and 33 females. The majority of them were under 5 years of age (71%). 25 children were immunocompromised due to chemotherapy, steroid or immunosuppressive treatment. Serogroup D was the most common isolates (65%) followed by B (16%), C (8%) and E (8%). Resistance rate of 30% to ampicillin, 12% to chloramphenicol, 20% to trimethoprim- sulfamethoxazole (TMP-SMX), 11% to cefotaxime and 8% to cefixime were obtained. All isolates were susceptible to ciprofloxacine. Resistance rate to cefotaxime and cefixime in immunocompromised patients was 24% and 14.3% respectively, which were significantly higher compared to that in immunocompetent patients (6.8%, 5.6%, p<0.05). 11 isolates were resistant to three or more antibiotics. The incidence of multi-drug resistant isolates was significantly higher in immunocompromised patients (24%) than that of immunocompetent patients (6.8%). CONCLUSION: Because of the high prevalence of non-typhoidal salmonella strains resistant to ampicillin, chloramphenicol and TMP-SMX, third-generation cephalosporin might be the treatment of choice in non-typhoidal salmonella gastroenteritis. In particular, antibiotics should be carefully selected in immunocompromised patients because non-typhoidal salmonellas from them showed the higher incidence of antibiotic resistance and multi-drug resistance.
