Related Experiment Videos
[Persistence of colonization time in patients infected by Salmonella]
E N Berezin1, E da S Carvalho, C K Farhat
1Fac. de Med., Santa Casa de São Paulo.
Insights
Salmonella non typhi infections in children can lead to prolonged carrier states, with persistent bacterial excretion lasting up to 24 weeks. This extended shedding poses a significant risk for spreading Salmonella within hospital and home environments.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Epidemiology
Context:
- Salmonella non typhi infections are a notable cause of hospital-acquired infections in children.
- Historically, these infections reached endemic levels in Brazil during the 1970s and 1980s.
Purpose:
- To prospectively investigate the duration of Salmonella non typhi carrier status in acutely infected children.
- To determine the clinical repercussions of persistent Salmonella excretion.
Summary:
- Twenty-five children (4-180 days old) with acute Salmonella non typhi infection were monitored monthly for carrier status via cultures from multiple sites.
- Persistent Salmonella excretion was observed in 72% at 4 weeks, 40% at 16 weeks, 16% at 20 weeks, and 4% at 24 weeks post-diagnosis.
- Biotyping confirmed consistent bacterial strains throughout the carrier period, indicating prolonged excretion.
Impact:
- Findings highlight the potential for persistent Salmonella excretion to last up to 24 weeks in pediatric patients.
- This prolonged shedding represents a significant source for disseminating Salmonella to hospital and household contacts.
- While antibiotics improved acute symptoms, they did not prevent the development or resolution of the carrier state.
Abstract:
Salmonella is an important etiological agent of hospital infection in children, reaching endemic levels in some Brazilian states during the seventies and the eighties. We have prospectively studied twenty five children between four and one hundred eighty days old acutely infected with salmonella non typhi to determine the duration of carrier status and its clinical repercussion. After the diagnosis, the children were submitted monthly to clinical examination, and cultures were collected from skin, oropharynx, urine, stools, genitals, nostrils and auditive conduct. During the follow-up, eighteen (72%) children still had positive culture at four weeks after the diagnosis, ten (40%) at sixteen weeks, four (16%) at twenty weeks, and one (4%) at twenty four weeks. In eleven children, we performed biotype and antibiotic susceptibility study of the bacteria recovered at the diagnosis and during the follow-up. In every child the biotype of the bacteria recovered at the diagnosis and during the follow-up was the same. These data indicate that there is a persistent excretion of salmonella that can last for 24 weeks. Such bacterial elimination may be a dissemination source either to hospital or to home contacts. The use of specific antibiotics was effective for the clinical improvement of the patients during the acute disease, but it didn't avoid the carrier state.