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Chloramphenicol resistant strains in salmonellosis in Jakarta
Insights
Salmonellosis in children is often caused by S. typhi or S. enteriditis. A significant portion of these infections showed resistance to chloramphenicol, impacting treatment and outcomes.
Area of Science:
- Pediatrics
- Microbiology
- Infectious Diseases
Background:
- Salmonellosis is a common bacterial infection in children.
- Antibiotic resistance is a growing concern in treating infectious diseases.
Purpose of the Study:
- To investigate the prevalence of salmonellosis in pediatric patients.
- To determine the antibiotic resistance patterns, particularly to chloramphenicol, in isolated Salmonella strains.
- To assess the clinical outcomes and mortality rates associated with salmonellosis.
Main Methods:
- Prospective observational study over 20 months.
- Clinical data collection from 123 children with suspected salmonellosis.
- Microbiological examination of stool, urine, blood, and cerebrospinal fluid for Salmonella isolation.
- Antimicrobial susceptibility testing, focusing on chloramphenicol resistance.
Main Results:
- Salmonella species (S. typhi or S. enteriditis) were isolated in 85% of cases.
- 27% of isolates were resistant to chloramphenicol, with S. sero-group C1 being predominant.
- The overall mortality rate was 7%, with four deaths occurring in the chloramphenicol-resistant group.
Conclusions:
- Chloramphenicol resistance is a significant issue in pediatric salmonellosis cases.
- Alternative antibiotics guided by sensitivity testing are crucial for managing resistant infections.
- Prompt diagnosis and appropriate antibiotic selection are vital for reducing mortality in pediatric salmonellosis.
Abstract:
During an observation period of 20 months (from January 1978 to September 1979) 123 children with clinically suspected salmonellosis were admitted to the Department of Pediatrics, 70 males and 53 females varying in age from 17 days to 14 years. S. typhi or S. enteriditis was isolated from the stool, urine, blood or cerebrospinal fluid in 85% (105/123) of the cases. The results of the microbiologic examination showed that 28 out of the 105 cases (27%) were resistant to chloramphenicol of which the S. sero-group C1 was predominant. It appeared that 28 cases conformed to the clinical data. In all these cases chloramphenicol was replaced by other antibiotics according to the sensitivity test. The mortality rate was 7% (9/123). Four of the fetal cases were from the chloramphenicol resistant group.