Epidemiologic and Clinical Features of Salmonellosis in Children over 10 Years(1986-1995)

Nah, Song Yi; Park, Jin Young; Lee, Hoan Jong; Seo, Jeong Kee

Abstract

BACKGROUND: With the improvement of sanitary conditions, epidemiologic features and relative frequency of serogroups of salmonella have changed in developed countries. Also there are increasing reports on occurrence of multidrug-resistant salmonella infections. To investigate such changes in Korean children, we retrospectively evaluated epidemiologic features of salmonellosis and antibiotic resistance pattern.
METHODS
Medical records of patients, whose blood or stool culture yielded Salmonella sp. were reviewed. Then serogroup, monthly occurrence, clinical syndromes, and antibiotic resistance were evaluated.
RESULTS
During the period from January 1986 to December 1995, 166 cases of salmonellosis had been admitted to the Seoul National University Children's Hospital. Group B salmonella was most frequently isolated (48.8%), followed by non-typhoidal group D, group C, and Salmonella typhi. S. typhi was frequently isolated from blood, in contrast with other serogroups from stool. The isolation of S. typhi has been decreasing, while that of non-typhoidal group D and group B has been increasing in the nineties. Forty-two percent were isolated from July to September. Group B was responsible for 54% of the gastroenteritis cases. Among the cases presenting with fever without a primary focus, S. typhi was isolated from blood in 16 cases and group B from blood or stool in 10 cases. Sixty- eight percent of gastroenteritis occurred in children of 2 years or below in age, while most cases of enteric fever occurred in school-age children. Group D strains including S. typhi were susceptible to most antibiotics, such as ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, ciprofloxacin, and ceftriaxone, but more than half of group B strains were resistant to ampicillin and chloramphenicol.
CONCLUSION
The occurrence of typhoid fever has been decreasing markedly, but salmonella gastroenteritis by group B and non-typhoidal group D has been increasing in the nineties. Resistance to the primary antibiotics used for the treatment of salmonellosis was observed in the group B strains.