Related Experiment Videos
Salmonella, Shigella, and Campylobacter: common bacterial causes of infectious diarrhea
1Pediatric Infectious Diseases, Memorial Miller Children's Hospital, Long Beach, California 90801-1428.
Insights
Salmonella, Shigella, and Campylobacter cause common bacterial enteritis in children. Suspect bacterial causes in severe or persistent diarrhea, especially with toxic signs, and consider extraintestinal spread in vulnerable groups.
Area of Science:
- Pediatrics
- Infectious Diseases
- Gastroenterology
Background:
- Salmonella, Shigella, and Campylobacter are leading causes of acute bacterial enteritis in the US.
- Bacterial enteritis requires serious consideration in children with rapid symptom progression or prolonged diarrhea.
Purpose of the Study:
- To outline diagnostic considerations for bacterial enteritis in children.
- To provide guidance on managing extraintestinal dissemination and antibiotic therapy.
Main Methods:
- Clinical observation and case review of pediatric patients with acute bacterial enteritis.
- Review of diagnostic criteria and treatment guidelines for Salmonella, Shigella, and Campylobacter infections.
Main Results:
- Bacterial enteritis should be suspected in children with rapid progression from secretory to inflammatory diarrhea, persistent diarrhea (>5-6 days), or toxic appearance disproportionate to dehydration.
- Extraintestinal dissemination is rare, except in infants <1 year and immunocompromised individuals, warranting blood cultures and empiric antibiotics.
- Oral antibiotics are generally sufficient for Shigella and Campylobacter infections when indicated.
Conclusions:
- Prompt recognition of bacterial enteritis in children is crucial for appropriate management.
- Handwashing and personal hygiene are essential preventive measures, particularly for Shigella due to its low infectious dose.
- Tailored antibiotic strategies are necessary based on the specific pathogen and patient risk factors, including potential for systemic spread.
Abstract:
Salmonella, Shigella, and Campylobacter species are the most common causes of acute bacterial enteritis in the United States. These pathogens should be considered seriously in children who progress rapidly from secretory to inflammatory diarrhea syndrome or in whom diarrhea persists beyond 5 to 6 days. Furthermore, children who appear more toxic than their state of dehydration would suggest should be suspected of having an acute bacterial etiology for their diarrhea. Systemic, extraintestinal dissemination of these organisms is uncommon, with the exception of salmonella infection during the first year of life and in immunocompromised hosts. In this latter situation, culture of blood and other appropriate body fluids should be considered, along with empiric systemic antibiotic therapy. When antibiotics are warranted in patients with shigella or campylobacter infection, oral therapy is usually sufficient. Careful attention to handwashing and personal hygiene is always appropriate to prevent further spread of these organisms. The very low infectious dose of shigella infection mandates an even more compulsive attention to these latter recommendations when this organism is implicated.