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Published on: July 22, 2012
Asymptomatic salmonellosis among children in day-care centers in Mérida, Yucatan, Mexico
R A Oberhelman1, J Flores-Abuxapqui, G Suarez-Hoil
1Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA. oberhel@tulane.edu
Insights
Salmonella was the most common enteropathogen in Mexican child day-care centers (DCC). Multiple sources of Salmonella infection were identified in children and teachers, complicating infection control efforts.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Child day-care centers (DCC) are increasingly prevalent globally, presenting unique health challenges.
- Limited data exists on enteropathogen prevalence in DCC within tropical, developing countries.
- Diarrhea is a known issue in DCC, but specific pathogen data is scarce.
Purpose of the Study:
- To conduct a 12-month longitudinal surveillance of enteropathogens in two child day-care centers (DCC) in Mérida, Mexico.
- To identify the prevalence and types of enteropathogens affecting children attending DCC.
- To investigate potential sources of infection within the DCC environment.
Main Methods:
- A 12-month surveillance study involving 78 children (2 months to 4 years) in two Mérida DCC.
- Monthly stool cultures were performed on children, with demographic and clinical data collected.
- Enteropathogens were identified using microbiological culture techniques.
Main Results:
- Salmonella species were the most frequent enteropathogen (6.7%), particularly in children under 18 months.
- Giardia lamblia (3.0%) and LT-producing enterotoxigenic Escherichia coli (2.3%) were also identified.
- Salmonella was detected in teachers (10.6%) and multiple serotypes suggested diverse infection sources, not a single outbreak.
Conclusions:
- Multiple sources of Salmonella infection are present in Mexican child day-care centers.
- The diversity of Salmonella serotypes complicates effective infection control strategies.
- These findings highlight the need for targeted interventions in DCC settings in developing countries.
Background:
Child day-care centers (DCC) have become common in many lower and middle income countries, presenting new problems that may differ from those of DCC in more developed countries. Diarrhea is a common problem in DCC in the United States, but information on the prevalence of diarrhea or specific enteropathogens among children in DCC in tropical and developing countries is limited.
Methods:
Because of preliminary data from newborns and DCC attendees in Mérida, Mexico, with high rates of Salmonella infection, we conducted a 12-month longitudinal surveillance study of enteropathogens in two Mérida DCC. Seventy-eight children ages 2 months to 4 years were evaluated with demographic and clinical data, and stools were cultured monthly.
Results:
Salmonella sp. was the most common enteropathogen detected (46 of 683 specimens, 6.7%), with higher rates in children younger than 18 months (P < 0.02), but it was found in only 1 of 10 diarrhea episodes that coincided with sampling. Other common organisms identified included Giardia lamblia (21 of 683, 3.0%) and LT-producing enterotoxigenic Escherichia coli (16 of 683, 2.3%). Salmonella was recovered from as many as 19% of children in a single month, but the large multiplicity of serotypes recovered suggested multiple sources rather than a common source outbreak. Children with Salmonella tended to have more liquid stools during the preceding 2 weeks. Salmonella was also isolated from the stool of teachers in 1 of the 2 DCC in 10 of 94 specimens (10.6%), and again multiple serotypes were represented.
Conclusion:
These data indicate the presence of multiple sources of Salmonella infection in the DCC, posing a complex situation for infection control.
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