Salmonella infections in infants and children

Salmonella is an important pathogen for infants and children of which multiply resistant strains were recently reported. Our interest was the annual variation of clinical manifestations, serotype and the sensitivity rate for antibiotics during the past decade. Increased incidence of bacteremia in infants is reported. In order to find the predisposing factors of patients with acute gastroenteritis complicated with bacteremia, we conducted a retrospective analysis.

We reviewed the records of documented patients who had positive culture for Salmonella in our Pediatric Department from September 1982 to September 1992. Those patients with acute gastroenteritis were divided into two groups: I, those complicated with bacteremia and II, non-bacteremic cases. Then we compared the age, body temperature, severity of clinical symptoms, white blood cell count and Salmonella serotype of these two groups.

There were 180 cases of Salmonella infection in our Pediatric Department during the past decade. The mean age was 14.80 months. Most (88.9%) patients were under two years old and 146 subjects were victims of acute gastroenteritis. Six cases had infection of the central nervous system (CNS). Five cases presented typhoid fever. Of three mortal cases, two died from meningitis with sepsis and one was a victim of malignant lymphoma and septic arthritis complicated with sepsis. Salmonella group B was the most common pathogen. There were no cases of typhoid fever after 1989. The sensitivity to ampicillin, chloramphenicol, and ceftriaxone for group B were 25.7%, 26.1% and 100% respectively. Multiply resistant Salmonella species were not present in our cases. The severity of clinical symptoms varied in significantly between those who had acute gastroenteritis with bacteremia (Group I) and those who had acute gastroenteritis without bacteremia (Group II). However, there was a significant distinction in the average age of the two groups (P = 0.005).

Although the annual number of cases did not decrease in recent years, the number of cases of typhoid fever did decrease. Most patients were infants and acute gastroenteritis was most common. In our series, the relative sensitivity for ampicillin, chloramphenicol was small over the past decade. Multiply resistant Salmonella species were not found, which may be due to the small sample size.