Clinical Evaluation of Group B Salmonellosis

Abstract

Background: Salmonella infections in human present a spectrum of clinical syndromes that include enteric fever, acute gastroenteritis, bacteremia, localized infections, asymptomatic intestinal infections and transient, convalescent and chronic intestinal carrier states. Recently the incidence of reported nontyphoidal Salmonella cases has increased. Among them, group B Salmonella is an important enteric pathogen and increased incidence of bacteremia in infants is also reported. We performed a retrospective analysis to evaluate the incidence of group B Salmonella infection, the clinical manifestation, the laboratory findings and the pattern of susceptibility to commonly used antibiotics. Methods: The serogroups of Salmonella strains isolated from stool and blood from June 1994 to September 1995 were typed and the antimicrobial susceptibility was tested by agar diffusion method. We reviewed clinical records of patients who had positive culture for group B Salmonella. The age, sex, body temperature, white blood cell count and Widal test results of those patients were analyzed. Results: 1. Among 124 strains, group B Salmonella was 58(48.8%). 2. About 57% of patients were infants and early childhood and most of cases(77.6%) occurred between May and October, 3. Two patients(4.7%) were associated with bacteremia. 4. The resistance to Tetracycline, Ampicillin, Trimethoprim-Sulfamethoxazole (TMP-SXT), cefamandole and ceftriaxone for group B was 62%, 32.7%, 8.6%, 1.7% and 0% respectively. Multiple resistant strains were 7(12.1%). Conclusion: Most patients with acute gastroenteritis due to group B Salmonella are under two years old and the resistant strains to first line antibiotics have increased. Young infants are at particular risk for bacteremia, so if group B Salmonellosis is suspected in infants, blood culture should be obtained and proper antibiotic therapy should be given.