Multidrug resistant Salmonella Concord is a major cause of salmonellosis in children in Ethiopia

Introduction: S. Concord in Ethiopia. The objective of this study was to determine the aetiology of febrile and diarrhoeic illness in Ethiopian children focussing on Salmonella. Methodology: Paediatric patients (n = 1,225) presenting with diarrhoea or fever from the paediatric outpatient department of Tikur Anbessa University Hospital, Addis Ababa (n = 825), and Jimma University Hospital, South West Ethiopia (n = 400), were investigated for pathogens from January to August 2006. Results: Parasites were detected in 337 cases, Salmonella in 65, and Shigella in 61. Serotyping of Salmonella (including 48 stored isolates) demonstrated the dominance of S. Concord: S. Concord (85), S. Typhimurium (7), S. Paratyphi B (2), S. Haifa (1), S. Typhi (2), S. Enteritidis (4), S. Butantan (2), S. Infantis (1), S. Pomona (1), Salmonella group M (28: y:-) (1), and S. Oskarshamn (1). Six isolates in serogroups B and D were untypeable. Of 81 S. Concord isolates, 30% were invasive, most (86.5%) were positive for ESBL production by E-test and 70% were multiply resistant to trimethoprim-sulphamethaxole, ceftriaxone, chloramphenicol and gentamicin, of which over one quarter (27%) also showed reduced susceptibility to ciprofloxacin. Conclusion: Multi-drug resistant S. Concord was the major cause of salmonellosis in two regions of Ethiopia. The strain isolated was highly invasive, highly antibiotic-resistant, and represents a threat to heath care globally.