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Salmonella bloodstream infection in Ghanaian children
Julia Wilkens1, Mercy J. Newman, Joseph Oliver Commey
1Institute of Medical Microbiology and Hygiene, University of Cologne, Germany; and.
Insights
Community-acquired Salmonella bloodstream infections are common in Ghanaian children, with Salmonella enteritidis being the most frequent isolate. Antibiotic resistance was observed in these Salmonella strains, posing a significant health concern.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Salmonella bloodstream infections are a significant cause of morbidity and mortality in children, particularly in resource-limited settings.
- Understanding the epidemiology and antimicrobial resistance patterns of Salmonella is crucial for effective treatment and public health strategies.
Purpose of the Study:
- To determine the incidence of community-acquired Salmonella bloodstream infections in Ghanaian children.
- To investigate the antibiotic resistance profiles of Salmonella isolates from blood cultures.
- To compare clinical characteristics and outcomes of children with Salmonella bloodstream infections to control groups.
Main Methods:
- A prospective study was conducted over 3 months at Korle Bu Teaching Hospital, Accra, Ghana.
- Blood cultures were obtained from 472 pediatric patients admitted within 48 hours.
- Salmonella isolates were speciated, and antibiotic susceptibility testing was performed. Clinical data were compared between cases and controls.
Main Results:
- Salmonella was identified in 21.6% of pathogen-positive blood cultures (n=24).
- Salmonella enteritidis (59%) was more common than Salmonella typhi (25%).
- Antibiotic resistance was noted in 57% of S. enteritidis isolates. Infected children presented with more severe symptoms and longer hospital stays.
Conclusions:
- Community-acquired Salmonella bloodstream infection is a notable health issue in Ghanaian children, with non-typhoidal strains being prevalent.
- The emergence of antibiotic resistance in Salmonella isolates, particularly S. enteritidis, complicates treatment options.
- Effective management strategies and antimicrobial stewardship are essential to address this public health challenge.
Abstract:
OBJECTIVE: To examine the frequency of community-acquired salmonella bloodstream infection in Ghanaian children and the occurrence of antibiotic resistance in salmonellae. METHODS: The study comprised 472 patients with a blood culture obtained within 48 h of admission to the pediatric department of Korle Bu Teaching Hospital in Accra, Ghana, over a 3-month period. All Salmonella isolates from blood cultures were speciated and antibiotic susceptibility tests were performed. Clinical data of children with salmonella bloodstream infection were compared to those of controls. Two control groups were identified: all children enrolled in the study without salmonella bloodstream infection (group 1), and those with bloodstream infection due to other organisms (group 2). RESULTS: A pathogen was isolated from 111 children (23.5%), and salmonellae were among the most common isolates (n=24; 21.6%). Among Salmonella strains, S. enteritidis (n=14; 59%) predominated over S. typhi (n=6; 25%). Resistance to several antibiotics was only found in S. enteritidis isolates (n=8; 57%). Children with salmonella bloodstream infection presented more often than controls with severe anemia, jaundice, abdominal pain and distension as well as hepatomegaly and splenomegaly. They were also hospitalized for a significantly longer period, but the case-fatality rate was similar. CONCLUSIONS: Salmonella bloodstream infection, especially due to non-typhoidal strains, is a potential health problem for Ghanaian children and may be complicated by resistance to the commonly available antibiotics.