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Epidemiology and molecular identification of Salmonella infections in children
G E Schutze1, R S Kirby, E L Flick
1Department of Pediatrics and Pathology, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock 72202-3591, USA. schutzegordone@exchange.uams.edu
Insights
Most childhood Salmonella infections are sporadic, with unidentified sources. While common food sources weren't found for linked cases, environmental contamination is a likely culprit for pediatric salmonellosis.
Area of Science:
- Pediatric Infectious Diseases
- Foodborne Illness Epidemiology
- Microbial Genetics
Background:
- Salmonella infections pose a significant risk to infants and children.
- Identifying the sources of Salmonella transmission is crucial for public health interventions.
Purpose of the Study:
- To investigate the role of food and environmental factors in pediatric Salmonella infections.
- To determine the sources of Salmonella transmission in children under 4 years old.
Main Methods:
- A case-controlled survey involving children under 4 years old with Salmonella infections and age-matched controls.
- Pulsed-field gel electrophoresis (PFGE) was used for DNA fingerprinting of Salmonella isolates.
- Statistical analysis included Mantel-Haenszel chi-squared tests and Fisher exact tests, with Bonferroni correction.
Main Results:
- Dietary habits were largely similar between cases and controls, with some exceptions in salad consumption.
- PFGE analysis revealed that most Salmonella infections were caused by unique isolates, with few instances of shared strains.
- Geographic clustering was observed in a small subset of patients with identical Salmonella isolates.
Conclusions:
- The majority of pediatric Salmonella infections appear sporadic, with the primary source often remaining unidentified.
- Common food sources could not be definitively linked to cases with identical Salmonella isolates.
- Epidemiological data suggest environmental contamination or other unidentified sources play a role in pediatric salmonellosis.
Objective:
To explore the role of foods and the environment in the development of infections with Salmonella in infants and children.
Design:
Case-controlled survey and the use of pulsed-field gel electrophoresis to establish DNA fingerprint patterns.
Setting:
Ambulatory and hospitalized patients at a children's hospital.
Patients Or Other Participants:
A consecutive sample of children younger than 4 years old who were infected with Salmonella and 3 age-matched controls per patient were to be surveyed. Of the 103 eligible cases of salmonellosis, 90 cases and 264 controls were included in the study.
Data Analysis:
Univariate analysis was done using the Mantel-Haenszel chi2 test or the Fisher exact test. The Bonferroni correction was used for multiple comparisons. DNA fingerprints were inspected for identical banding.
Results:
Results demonstrated similar diets between cases and controls with the exception of more potato or macaroni salad or coleslaw consumption in the control group (P<.001). DNA fingerprints of Salmonella newport and Salmonella typhimurium demonstrated that all cases were due to unique isolates except in 5 instances involving 12 patients. Seven of these patients could be connected geographically.
Conclusions:
Most of the cases of salmonellosis in children younger than 4 years are of a sporadic nature and the major source of infection remains unidentified. For patients infected with identical isolates of Salmonella, a common food source could not be incriminated with the methods used. Environmental contamination or other sources of Salmonella are suggested by these epidemiological data.