All issues > Volume 52(7); 2009

Original Article

Korean J Pediatr. 2009;52(7):791-797. Published online July 15, 2009.

Salmonellosis in children: Analysis of 72 Salmonella-positive culture cases during the last 10 years

Sung Hoon SH Noh¹, Ka Young KY Yu¹, Jung Soo JS Kim², Pyoung Han PH Hwang², Dae Sun DS Jo²

¹Department of Pediatrics, Chonbuk National University Medical school, Jeonju, Korea
²Chonbuk National University Medical school, Research Institute of Clinical Medicine, Jeonju, Korea

Abstract

Purpose
: We aimed to investigate the clinical manifestations of and antibiotic resistance in culture-proven childhood salmonellosis.
Methods
: Clinical manifestations and laboratory data of and antibiotic use in subjects with culture-proven childhood salmonellosis, who were treated at the Chonbuk National University Hospital between September 1998 and August 2008, were analyzed retrospectively. Patients with underlying diseases or concomitant illnesses were excluded.
Results
: We assessed a total of 72 patients. There were 68 stool culture-positive cases, 7 blood culture-positive cases, and 3 both stool culture- and blood culture-positive cases. Salmonella group D was the most frequent pathogen in stool (63.9%) and blood (71.4%) cultures. Salmonella typhi was isolated in 1 case. Of the 72 patients, 45 (62.5%) were male children, of which 29 (40.3%) were aged <3 years. The patients most commonly presented with diarrhea (90.2%) and fever (83.3%). Leukocytosis (leukocyte count, >15,000/µL) and leukopenia (leukocyte count, <4,000/µL) were detected in 8.3% and 5.6% of the patients, respectively. Elevated serum C-reactive protein concentration (>5 mg/dL) and erythrocyte sedimentation rate (>20 mm/h) were observed in 88.9% and 58.3% of the patients, respectively. Fifty-two (85.2%) of 61 patients who had undergone antibiotic treatment received a third-generation cephalosporin as definitive antibiotic therapy. Multidrug resistance rate was 40.0 % in the first 5 years of the study and 71.4% in the last 5 years. No fatalities occurred in this series.
Conclusion
: Children with culture-proven salmonellosis showed relatively benign clinical outcomes. Appropriate antibiotic treatment of <2 weeks is probably adequate for those without a suppurative focus of infection. The incidence of antibiotic resistant isolates was recently seen to increase.

Keywords :Salmonella infection, Children, Antibiotic resistance