[Non-typhi Salmonella bacteremia in children: an 11-year review]

To review the clinical and bacteriological features of pediatric patients with non-typhi Salmonella (NTS) bacteremia.

We reviewed the medical records of children aged less than 14 years with culture-proven NTS bacteremia in the previous 11 years in a referral hospital in Madrid, Spain.

A total of 29 cases of NTS bacteremia were diagnosed. Of these, 27 were used for study purposes. The mean age was 11.1 months (range: 3 days to 11 years); 48% were infants aged < 1 year. Eleven children (41%) had an underlying disease. These included immunodeficiency in seven (malignant disease in three, IgA-IgG2 deficit in one, chronic granulomatous disease in one, HIV infection in one, and systemic lupus erythematosus in one patient on steroid treatment), liver disease in three, and hypoxic-ischemic encephalopathy in one. Clinical manifestations at the initial visit included: fever > 39 C (85%), diarrhea (67%), and vomiting (37%). Seven patients had occult bacteremia. Three children (11 %) required intensive care management for severe sepsis. Five patients presented extraintestinal focal infections: arthritis in two, osteomyelitis in one, urinary tract infection in one, and pneumonia in one. None of the children had meningitis or died as a result of NTS infection. The most common serogroups isolated were Salmonella D9, and B4-5 (38% each). Eleven strains (38%) were resistant to amoxicillin and five (17%) were resistant to cotrimoxazole. Only one patient developed persistent bacteremia. All the children made a complete recovery without further complications.

NTS bacteremia is an uncommon entity but it should be considered in infants and immunocompromised children. Although focal complications may occur, the usual outcome with appropriate antimicrobial treatment is a full recovery.