1887

Abstract

In Africa, multidrug-resistant non-typhoidal salmonellae (NTS) are one of the leading causes of morbidity and high mortality in children under 5 years of age, second in importance only to pneumococcal disease. The authors studied NTS isolates from paediatric admissions at two hospitals in Nairobi, Kenya, and followed the index cases to their homes, where rectal swabs and stools from parents and siblings, and from animals in close contact, were obtained. The majority of NTS obtained from cases were serotype Typhimurium (106 out of 193; 54·9 %) and serotype Enteritidis (64; 33·2 %), a significant proportion (34·2 %) of which were multiply resistant to three or more antibiotics, including ampicillin, tetracycline, cotrimoxazole and chloramphenicol. Only 23·4 % of NTS were fully susceptible to all 10 antibiotics tested. Of the 32 NTS obtained from contacts (nine adults and 23 children) at the homes of index cases, 21 (65·6 %) isolates were similar by antibiotic-susceptibility profiles and plasmid content, and their I- and I-digested chromosomal DNA patterns were indistinguishable from those of the corresponding index cases. Only three out of 180 (1·7 %) samples from environmental sources, including animals, soil, sewers and food, contained NTS matching those from corresponding index cases. The carriage of NTS in an asymptomatic population was represented by 6·9 % of human contacts from 27 out of 127 homes sampled. This population of carriers may represent an important reservoir of NTS that would play a significant role in the epidemiology of community-acquired NTS bacteraemia in children.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.46375-0
2006-05-01
2024-03-29
Loading full text...

Full text loading...

/deliver/fulltext/jmm/55/5/585.html?itemId=/content/journal/jmm/10.1099/jmm.0.46375-0&mimeType=html&fmt=ahah

References

  1. Adejuyigbe E. A., Ako-Nai A. K., Adisa B. 2004; Bacterial isolates in the sick young infant in Ile-Ife, Nigeria. J Trop Pediatr 50:323–327 [CrossRef]
    [Google Scholar]
  2. Angulo F. J., Johnson K. R., Tauxe R. V., Cohen M. L. 2000; Origins and consequences of antimicrobial-resistant nontyphoidal Salmonella : implications for the use of fluoroquinolones in food animals. Microb Drug Resist 6:77–83 [CrossRef]
    [Google Scholar]
  3. Bahwere P., Levy J., Hennart P., Donnen P., Lomoyo W., Dramaix-Wilmet M., Butzler J. P., De Mol P. 2001; Community-acquired bacteremia among hospitalized children in rural central Africa. Int J Infect Dis 5:180–188 [CrossRef]
    [Google Scholar]
  4. Berkley J. A., Lowe B. S., Mwangi I. & 11 other authors; 2005; Bacteremia among children admitted to a rural hospital in Kenya. N Engl J Med 352:39–47 [CrossRef]
    [Google Scholar]
  5. Bonfiglio G., Simpore J., Pignatelli S., Musumeci S., Solinas M. L. 2002; Epidemiology of bacterial resistance in gastro-intestinal pathogens in a tropical area. Int J Antimicrob Agents 20:387–389 [CrossRef]
    [Google Scholar]
  6. Centers for Disease Control and Prevention; 1999; Reptile-associated salmonellosis–selected states, 1996–1998. Morbid Mortal Wkly Rep 48:1009–1013
    [Google Scholar]
  7. Cheesbrough J. S., Taxman B. C., Green S. D., Mewa F., Numbi I. 1997; A clinical definition for invasive Salmonella infection in African children. Pediatr Infect Dis J 16:277–283 [CrossRef]
    [Google Scholar]
  8. Cherubin C. E., Fodor T., Denmark L., Master C., Fuerst H. T., Winter J. 1969; The epidemiology of salmonellosis in New York City. Am J Epidemiol 90:112–125
    [Google Scholar]
  9. Espi E., De Valk H., Vaillant V., Quelquejeu N., Le Querrec F., Wei F. X. 2005; An outbreak of multidrug-resistant Salmonella enterica serotype Newport infections linked to the consumption of imported horse meat in France. Epidemiol Infect 133:373–376 [CrossRef]
    [Google Scholar]
  10. Fierer J., Swancutt M. 2000; Non-typhoid Salmonella : a review. Curr Clin Top Infect Dis 20:134–157
    [Google Scholar]
  11. Gill C. J., Hamer D. H. 2001; Foodborne illnesses. Curr Treat Options Gastroenterol 4:23–38 [CrossRef]
    [Google Scholar]
  12. Graham S. M. 2002; Salmonellosis in children in developing and developed countries and populations. Curr Opin Infect Dis 15:507–512 [CrossRef]
    [Google Scholar]
  13. Green S. D., Cheesbrough J. S. 1993; Salmonella bacteraemia among young children at a rural hospital in western Zaire. Ann Trop Paediatr 13:45–53
    [Google Scholar]
  14. Hsueh P. R., Teng L. J., Tseng S. P. & 20 other authors; 2004; Ciprofloxacin-resistant Salmonella enterica Typhimurium and Choleraesuis from pigs to humans, Taiwan. Emerg Infect Dis 10:60–68 [CrossRef]
    [Google Scholar]
  15. Kariuki S., Revathi G., Gakuya F., Yamo V., Muyodi J., Hart C. A. 2002; Lack of clonal relationship between non-typhi Salmonella strain types from humans and those isolated from animals living in close contact. FEMS Immunol Med Microbiol 33:165–171 [CrossRef]
    [Google Scholar]
  16. Kariuki S., Revathi G., Muyodi J., Mwituria J., Munyalo A., Kagendo D., Murungi L., Hart C. A. 2005; Increasing prevalence of multidrug-resistant non-typhoidal salmonellae, Kenya, 1994–2003. Int J Antimicrob Agents 25:39–45
    [Google Scholar]
  17. Kassa-Kelembho E., Mbolidi C. D., Service Y. B., Morvan J., Minssart P. 2003; Bacteremia in adults admitted to the Department of Medicine of Bangui Community Hospital (Central African Republic). Acta Trop 89:67–72 [CrossRef]
    [Google Scholar]
  18. Lepage P., Bogaerts J., Van Goethem C., Hitimana D. G., Nsengumuremyi F. 1990; Multiresistant Salmonella typhimurium systemic infection in Rwanda. Clinical features and treatment with cefotaxime. J Antimicrob Chemother 26:53–57
    [Google Scholar]
  19. Mazurek J., Salehi E., Propes D., Holt J., Bannerman T., Nicholson L. M., Bundesen M., Duffy R., Moolenaar R. L. 2004; A multistate outbreak of Salmonella enterica serotype Typhimurium infection linked to raw milk consumption –. Ohio: 2003 J Food Prot 67:2165–2170
    [Google Scholar]
  20. Milledge J., Calis J. C., Graham S. M. & 8 other authors; 2005; Aetiology of neonatal sepsis in Blantyre, Malawi: 1996–2001. Ann Trop Paediatr 25:101–110 [CrossRef]
    [Google Scholar]
  21. Molyneux E. M., Tembo M., Kayira K. & 7 other authors; 2003; The effect of HIV infection on paediatric bacterial meningitis in Blantyre. Malawi. Arch Dis Child 88:1112–1118 [CrossRef]
    [Google Scholar]
  22. Mwangi I., Berkley J., Lowe B., Peshu N., Marsh K., Newton C. R. 2002; Acute bacterial meningitis in children admitted to a rural Kenyan hospital: increasing antibiotic resistance and outcome. Pediatr Infect Dis J 21:1042–1048 [CrossRef]
    [Google Scholar]
  23. National Committee for Clinical Laboratory Standards 2002 Performance standards for antimicrobial susceptibility testing; twelfth informational supplement . Approved standard M100-S12 Wayne, PA: National Committee for Clinical Laboratory Standards;
    [Google Scholar]
  24. Tauxe R. V. 1997; Emerging food-borne diseases: an evolving public health challenge. Emerg Infect Dis 3:425–434 [CrossRef]
    [Google Scholar]
  25. Tenover F. C., Arbeit R. D., Goering R. V., Mickelsen P. A., Murray B. E., Persing D. H., Swaminathan B. 1995; Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 33:2233–2239
    [Google Scholar]
  26. Vaagland H., Blomberg B., Kruger C., Naman N., Jureen R., Langeland N. 2004; Nosocomial outbreak of neonatal Salmonella enterica serotype Enteritidis meningitis in a rural hospital in northern Tanzania. BMC Infect Dis 4:35–37 [CrossRef]
    [Google Scholar]
  27. Varma J. K., Greene K. D., Ovitt J., Barrett T. J., Medalla F., Angulo F. J. 2005; Hospitalization and antimicrobial resistance in Salmonella outbreaks, 1984-2002. Emerg Infect Dis 11:943–946 [CrossRef]
    [Google Scholar]
  28. Wall P. G., Threlfall E. J., Ward L. R., Rowe B. 1996; Multi-resistant Salmonella typhimurium DT104 in cats: a public health risk. Lancet 348:471
    [Google Scholar]
  29. World Health Organization 2000 Overcoming antimicrobial resistance . Publication code WHO/CDS/2000.2 Geneva: World Health Organization;
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.46375-0
Loading
/content/journal/jmm/10.1099/jmm.0.46375-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error