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[Clinical features and drug resistance in children with Salmonella infection]
Ling Chen1, Xiao-Li Chen, Jia-Yin Wu
1Department of Clinical Laboratory, Xiamen Maternity and Child Health Care Hospital, Xiamen, Fujian 361003, China. yehuiming@xmu.edu.cn.
Insights
Children under one year old are most vulnerable to Salmonella infections, particularly Salmonella typhimurium, during warmer months. Fever and diarrhea are common symptoms, often accompanied by respiratory issues, and increasing resistance to certain antibiotics is noted.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Antimicrobial Resistance
Background:
- Salmonella infections pose a significant health risk to children.
- Understanding clinical features and resistance patterns is crucial for effective treatment.
Purpose of the Study:
- To investigate the clinical characteristics of Salmonella infections in hospitalized children.
- To determine the prevalence of different Salmonella serotypes.
- To assess the antimicrobial drug resistance patterns in pediatric Salmonella isolates.
Main Methods:
- Retrospective analysis of 163 children hospitalized with Salmonella infection (2013-2017).
- Data collected included clinical features, Salmonella serotypes, and drug sensitivity testing.
- Focus on patient demographics, symptomology, seasonality, and antibiotic resistance profiles.
Main Results:
- The majority of infected children (48.5%) were under one year old.
- Common symptoms included high fever (>39°C) and frequent diarrhea (>10 times/day); respiratory infections were also prevalent (34.4%).
- Salmonella typhimurium (61.3%) was the most common serotype, with infections peaking in summer and autumn (80.4%).
- High resistance rates (>20%) were observed for cefotaxime (a third-generation cephalosporin).
- Susceptibility was high for beta-lactamase inhibitors; no resistance to carbapenems was found.
Conclusions:
- Infants are particularly susceptible to Salmonella, with Salmonella typhimurium being the predominant serotype.
- Fever, diarrhea, and concurrent respiratory infections are key clinical indicators.
- Rising resistance to third-generation cephalosporins necessitates careful antibiotic selection based on sensitivity testing.
Objective:
To study the clinical features and drug resistance in children with Salmonella infection.
Methods:
A total of 163 children with positive fecal cultures for Salmonella who were hospitalized between 2013 and 2017 were enrolled. A retrospective analysis was performed for their data on clinical features, distribution of Salmonella serotypes, and drug sensitivity test results.
Results:
Among the 163 children with Salmonella infection, 79 (48.5%) were aged ≤1 year. Main clinical manifestations included fever and diarrhea. Of all the children, 121 (74.2%) reached a body temperature of above 39°C, 52 (31.9%) had diarrhea more than 10 times a day, and 56 (34.4%) had respiratory infection. Salmonella infection often occurred in summer and autumn. Of all the children, 131 (80.4%) had the infection in May to October. Salmonella typhimurium was observed in 100 children (61.3%) and Salmonella enteritidis was observed 15 children (9.2%). All serotypes of Salmonella had a drug resistance rate of >20% to cefotaxime, as well as high sensitivities to β-lactamase inhibitors (amoxicillin/clavulanic acid and piperacillin/tazobactam). There were no strains resistant to carbapenems including imipenem.
Conclusions:
Infants aged ≤1 year are susceptible to Salmonella infection in summer and autumn, and the most common serotype is Salmonella typhimurium. Main clinical manifestations are fever and diarrhea in children with Salmonella infection, and most children also have respiratory infection. Salmonella has an increased rate of drug resistance to third-generation cephalosporins. In clinical treatment, antimicrobial drugs should be used according to the results of drug sensitivity test.
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