Clinical profiles and antimicrobial resistance patterns of invasive Salmonella infections in children in China

Abstract

Invasive Salmonella infections result in a significant burden of disease including morbidity, mortality, and financial cost in many countries. Besides typhoid fever, the clinical impact of non-typhoid Salmonella infections is increasingly recognized with the improvement of laboratory detection capacity and techniques. A retrospective multicenter study was conducted to analyze the clinical profiles and antimicrobial resistance patterns of invasive Salmonella infections in hospitalized children in China during 2016–2018. A total of 130 children with invasive Salmonella infections were included with the median age of 12 months (range: 1–144 months). Seventy-nine percent of cases occurred between May and October. Pneumonia was the most common comorbidity in 33 (25.4%) patients. Meningitis and septic arthritis caused by nontyphoidal Salmonella (NTS) infections occurred in 12 (9.2%) patients and 5 (3.8%) patients. Patients < 12 months (OR: 16.04) and with septic shock (OR: 23.4), vomit (OR: 13.33), convulsion (OR: 15.86), C-reactive protein (CRP) ≥ 40 g/L (OR: 5.56), and a higher level of procalcitonin (PCT) (OR: 1.05) on admission were statistically associated to an increased risk of developing meningitis. Compared to 114 patients with NTS infections, 16 patients with typhoid fever presented with higher levels of CRP and PCT (P < 0.05). The rates of resistance to ampicillin, sulfamethoxazole/trimethoprim, ciprofloxacin, and ceftriaxone among Salmonella Typhi and NTS isolates were 50% vs 57.3%, 9.1% vs 24.8%, 0% vs 11.2%, and 0% vs 9.9%, respectively. NTS has been the major cause of invasive Salmonella infections in Chinese children and can result in severe diseases. Antimicrobial resistance among NTS was more common.

Antimicrobial resistance and virulence genes of invasive Salmonella enterica from children with bacteremia in north-central Nigeria

“… 1 – 3 Salmonella infection could manifest clinically as gastroenteritis (diarrhea, abdominal cramps, and fever) or a fatal febrile systemic infection (typhoid) that needs to be treated with antibiotics. 4 – 7 Focal conditions and asymptomatic carriers are possible and are significant sources of continued infection transmission. 8 Salmonella is a gram-negative, flagellated, with O, H, and Vi antigens.…”

Genomic investigation and nationwide tracking of pediatric invasive nontyphoidal Salmonella in China

“…Children are susceptible to acquiring invasive NTS (iNTS) disease 2 . Previous studies were mainly focused on the serovar and antimicrobial‐resistant phenotype of iNTS isolates; the genomic characteristics of pediatric iNTS infection and possible sources for iNTS transmission remain largely unknown in China 3 , 4 , 5 . Herein, we conducted a cutting‐edge investigation with whole‐genome sequencing (WGS) to understand iNTS in China and suggest potential sources for an emerging iNTS serovar.…”