Clinical features and risk factors associated with bacteremia of nontyphoidal salmonellosis in pediatric patients, 2010-2018

Background/purpose(s): This study aimed to investigate clinical features and antimicrobial susceptibility of inpatient children with nontyphoidal salmonellosis from 2010 to 2018. Methods: We retrospectively collected pediatric patients with nontyphoidal Salmonella infection confirmed by positive cultures in a tertiary medical center in Taiwan from 2010 to 2018. Patients' characteristics, clinical manifestations, and laboratory data were collected. Serogroup category and antimicrobial susceptibility were also analyzed. Results: Of total 569 isolates, ampicillin resistant rate was 53% in average, third-generation cephalosporin resistant rate was 6.7%, ciprofloxacin resistant rate was 9% and trimethoprim-sulfamethoxazole resistant rate was 30%. Compared to the resistant rates in 2010, the resistance rate of third generation cephalosporin was significantly higher (3.4% vs. 11%, p = 0.003) but that of ciprofloxacin was significantly lower (20% vs. 11%, p < 0.001) in 2018. Among 297 inpatients with nontyphoidal salmonellosis, Group D (38%) was the most common in the bacteremia patients whereas Group B (48%) was the most common in the non-bacteremia patients. Among 244 immunocompetent inpatients with community-acquired salmonellosis, the bacteremia patients had significantly longer fever duration and diarrhea duration before hospitalization (p < 0.001), and significant higher rate of anemia (p = 0.028) due to either thalassemia trait or prolonged disease course than the non-bacteremia patients. Conclusion: Third-generation cephalosporin was still the drug of choice for nontyphoidal Salmonella infection in children though the resistant rate increased progressively. Significant risk factors associated with bacteremia were longer fever and diarrhea duration and anemia due to either thalassemia trait or prolonged disease course in immunocompetent children. Copyright (C) 2020, Formosan Medical Association. Published by Elsevier Taiwan LLC.

Automated summary

This study investigated the clinical features and antimicrobial susceptibility of inpatient children with nontyphoidal salmonellosis from 2010 to 2018 in Taiwan. The results showed an increase in resistance to third-generation cephalosporin and a decrease in resistance to ciprofloxacin over this period. Bacteremia patients with nontyphoidal salmonellosis had longer fever and diarrhea durations and a higher rate of anemia compared to non-bacteremia patients.