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Convalescent excretion of Salmonella enteritidis in infants
A E Balfour1, R Lewis, S Ahmed
1Department of Microbiology, Victoria Infirmary NHS Trust, Glasgow, Scotland, UK.
Insights
Salmonella enteritidis PT4 can cause prolonged symptomless excretion in infants, especially those under one year old. This highlights the need to adapt infection control measures during outbreaks.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Salmonella enteritidis PT4 outbreaks pose a significant public health concern, particularly in nursery settings.
- Understanding the duration and patterns of Salmonella excretion is crucial for effective outbreak management.
Purpose of the Study:
- To investigate the fecal excretion of Salmonella enteritidis PT4 in infants following a point-source outbreak.
- To correlate excretion findings with recommendations from the Outbreak Control Team (OCT).
Main Methods:
- Retrospective laboratory-based survey.
- Microbiological confirmation of Salmonella enteritidis PT4 infection.
- Monitoring of fecal sample positivity over time.
Main Results:
- 34 cases (33 primary, 1 secondary) of Salmonella enteritidis PT4 infection were confirmed.
- 96% of fecal samples remained positive 4 weeks post-exposure, with no infant exhibiting symptoms or receiving antibiotics.
- Two infants under one year old continued to excrete the bacteria 22 weeks after the outbreak's onset.
Conclusions:
- Salmonella enteritidis PT4, similar to other serotypes, can lead to prolonged asymptomatic shedding in infected individuals.
- Infants, particularly those under one year, are susceptible to extended symptomless excretion.
- Current infection control strategies and exclusion criteria may require revision as an outbreak evolves.
Objectives:
To review the excretion of Salmonella enteritidis PT4 in the faeces of infants involved in a point-source outbreak in a nursery, and to relate these findings to advice given by the Outbreak Control Team (OCT).
Methods:
Retrospective laboratory-based survey.
Results:
Infection with S. enteritidis PT4 was microbiologically confirmed in 33 primary cases and one secondary case. Of the faeces submitted 4 weeks from exposure, 96% remained positive. None of the infants was symptomatic by this time, and none received antimicrobial treatment. Two infants aged less than 1 year were still excreting 22 weeks after the onset of the outbreak.
Conclusions:
As for other serotypes, S. enteritidis PT4 causes prolonged symptomless excretion after infection, particularly in infants aged less than 1 year. Infection control measures, including exclusion criteria, may need to be modified as an outbreak progresses.