P0549 NON-TYPHOIDAL SALMONELLA GASTROENTERITIS IN KOREAN CHILDREN: ANTIBIOTICS RESISTANCE AND CLINICAL FEATURES

Abstract

Introduction: As the incidence of non-typhoidal salmonella strains resistant to antibiotics has been increased, we investigated antibiotics resistance and clinical aspects of non-typhoidal salmonella gastroenteritis. Methods: The clinical features, antibiotics resistance, multi-drug resistance, and the difference in the incidence of antibiotics resistance according to the immune status of patients were studied in 99 children with positive stool culture for non-typhoidal salmonella from January 2000 to June 2002. Results: The majority of patients were under 5 years of age (71%). Twenty five children were immunocompromised due to chemotherapy, steroid or immunosuppressive treatment. Diarrhea, fever, and crampy abdominal pain were the most frequent initial symptoms. These symptoms usually subsided within 3 to 7 days except in the immunocompromised patients, in whom symptoms persisted longer. Serogroup D was the most common isolates (65%) followed by B (16%), C (8%), and E (8%). Resistance rates of 30% to ampicillin, 12% to chloramphenicol, 20% to trimethoprim-sulfamethoxazol (TMP-SMX), 11% to cefotaxime, and 8% to cefixime were obtained. Eleven isolates were resistant to three or more antibiotics. All isolates were susceptible to ciprofloxacine. Resistance rates were significantly higher in the immunocompromised patients than those in the immunocompetent patients (TMP-SMX; 40% vs 14% p0.05, cefotaxime; 24% vs 6.8% p<0.05, cefixime; 14.3% vs 5.6% p<0.05). The incidence of multi-drug resistant isolates was also significantly higher in the immunocompromised than that in the immunocompetent patients (24% vs 6.8% p<0.05). Conclusion: Considering antibiotics resistance and multi-drug resistance, antibiotic should be carefully selected when it is indicated particular in immunocompromised patients with non-typhoidal salmonella gastroenteritis.