Multidrug-resistant non-typhoid Salmonella infections in a medical center

Due to the high incidence of antimicrobial-resistant Salmonella in Taiwan, the emergence of multidrug-resistant Salmonella has become of particular concern. This retrospective study assessed the clinical features of patients with multidrug-resistant Salmonella treated from January 1998 through June 2000. A total of 201 children and 33 adults with multidrug-resistant Salmonella infections treated during a 2.5-year period were included. Sixty-percent of these patients had used antibiotics before multidrug-resistant Salmonella infection developed. The incidence of extra-intestinal infections was higher in adults (51.4%) than in children (4.9%). Infection with an invasive serotype of Salmonella, such as Salmonella choleraesuis, and host factors appeared to be predisposing factors for bacteremia or extra-intestinal infections. None of the patients had mortality attributable to multidrug-resistant salmonellosis. The increasing rate of resistance to third-generation cephalosporins and fluoroquinolones and the high multidrug-resistant rate of S. choleraesuis found in this study indicate the importance of judicious use of antimicrobial agents in both humans and animals to reduce the selection and spread of resistant strains.