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Multiply resistant nontyphoidal Salmonella gastroenteritis in children
E Maiorini1, E L Lopez, A L Morrow
1Infectious Diseases Service, Hospital de Niños Dr. Ricardo Gutierrez, Buenos Aires, Argentina.
The Pediatric Infectious Disease Journal
|February 1, 1993
Summary
Multiply resistant Salmonella gastroenteritis poses a significant pediatric challenge in Buenos Aires. Aggressive Salmonella strains demonstrate widespread antibiotic resistance, necessitating urgent public health attention.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Antimicrobial Resistance
Background:
- Salmonella gastroenteritis is a common childhood illness.
- Multiply resistant Salmonella strains present a growing public health concern, particularly in urban pediatric populations.
- Understanding the epidemiology and resistance patterns of Salmonella is crucial for effective treatment and control.
Purpose of the Study:
- To investigate the clinical characteristics and antimicrobial resistance patterns of multiply resistant Salmonella gastroenteritis in children.
- To identify the most common Salmonella serovars and their resistance profiles.
- To assess the prevalence of complications and mortality associated with these infections.
Main Methods:
- A retrospective study of 75 children diagnosed with multiply resistant Salmonella gastroenteritis between January 1990 and December 1991.
- Data collection included patient demographics, clinical presentation, infection acquisition source, and outcomes.
- Antimicrobial susceptibility testing was performed using minimum inhibitory concentration (MIC) studies for various antibiotics.
Main Results:
- The majority of infections (66.7%) were nosocomially acquired.
- Bloody stools and prolonged fever were common clinical features.
- High rates of resistance were observed against ampicillin, cephalothin, cefuroxime, nalidixic acid, rifampin, gentamicin, and tobramycin.
- Salmonella typhimurium was the predominant serovar (85.3%).
- Complications included enterocolitis, bowel perforation, pulmonary abscess, and bacteremia, with a mortality rate of 5.3%.
Conclusions:
- Multiply resistant Salmonella strains, particularly Salmonella typhimurium, represent a significant and aggressive pediatric problem in Buenos Aires.
- The high prevalence of antimicrobial resistance necessitates careful antibiotic selection and infection control measures.
- Further research into novel therapeutic strategies and preventative measures is warranted.