Korean J Pediatr Gastroenterol Nutr.  2002 Sep;5(2):150-157.

Non-typhoidal Salmonella Gastroenteritis in Childhood: Clinical Features and Antibiotics Resistance

• Na SY
• Kim BC
• Yang HR
• Jung SJ
• Lee KH
• Ko JS
• Lee HJ
• Kim EC
• Se JK

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.

Keyword

Non-typhoidal salmonella gastroenteritis; Antibiotics resistance

MeSH Terms

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
Ampicillin
Anti-Bacterial Agents
Cefixime
Cefotaxime
Chloramphenicol
Ciprofloxacin
Sulfamethoxazole