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[Retrospective study of Salmonella gastroenteritis in infants]
Unlabelled:
Sixty-four cases of Salmonellosis were retrospectively analyzed in Jan. 1985 to Dec. 1988 at the department of pediatrics, Veteran General Hospital, Taipei. Most of the cases (78%) occurred between May and October, the most common pathogenic organism isolated was B salmonella group (65.6%). Antibiotic susceptibility to ampicillin revealed remarkably decrease from 75% (1985) down to 11.7% (1988) and the most sensitive antibiotic agent was ceftriaxone (98.3%). Blood culture were obtained in 42 cases and patients with salmonella bacteremia were found in 10 cases (23.8%). Five of 17 patients under 3 month old showed positive blood culture. Four of 5 bacteremic patients were complicated individually with convulsion, failure to thrive, chronic diarrhea and one case expired. Four of 33 patients between 3 month and 1 year were bacteremic. Two of 4 bacteremic patients were respectively complicated with meningitis and hip-joint arthritis. The average duration of salmonella shedding was 37.5 days (range 4-180 days).
In Conclusion:
1. Salmonellosis hasn't decreased in the past 4 years and the resistance to ampicillin and chloramphenicol has increased. 2. Young infants are at particular risk for bacteremia and focal complication, so if salmonellosis is suspected in infants under 3 month old, blood culture should be obtained and proper antibiotic therapy should be given.
Insights
Salmonellosis remains a concern, with increasing ampicillin resistance observed. Young infants under three months are at high risk for severe Salmonella bacteremia and complications, necessitating prompt blood cultures and treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Context:
- Retrospective analysis of 64 pediatric Salmonellosis cases (1985-1988) at a major hospital.
- Seasonal peaks observed between May and October.
- Salmonella group B was the predominant serogroup identified.
Purpose:
- To analyze trends in pediatric Salmonellosis, including incidence, causative agents, antibiotic susceptibility, and complications.
- To assess the risk of bacteremia and associated outcomes in young infants.
- To evaluate antibiotic resistance patterns, particularly to ampicillin.
Summary:
- A significant decrease in ampicillin susceptibility (75% to 11.7%) was noted over the study period.
- Ceftriaxone demonstrated high efficacy (98.3% susceptibility).
- Bacteremia occurred in 23.8% of cases, with higher rates in infants under three months (29.4%).
- Complications included convulsions, failure to thrive, chronic diarrhea, meningitis, and arthritis; one fatality occurred.
- Average Salmonella shedding duration was 37.5 days.
Impact:
- Highlights the rising ampicillin resistance in pediatric Salmonellosis, underscoring the need for updated treatment guidelines.
- Emphasizes the critical risk of bacteremia and severe complications in infants under three months.
- Recommends early blood culture and appropriate antibiotic therapy for suspected Salmonellosis in this vulnerable population.