Salmonella spp acute enterocolitis - an overview of antibiotic therapy and chemosensitivity patterns among children

Abstract

Background Acute Salmonella spp infections represent an important public health issue worldwide, particularly among children. Romania is a country with endemic Salmonella infections which reports occasionally summer outbreaks. Our study aimed to analyze the submitted cases and to appreciate the germ’s susceptibility to antibiotics, starting from the urging issue related to the emerging resistance of Enterobacteriaceae to common drugs. Methods We conducted a clinic-based retrospective (2010-2013) surveillance that analyzed the confirmed pediatric cases of Salmonella spp infections treated at the National Institute for Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, Romania. The clinical and demographic patient features followed were: age, sex, home environment, severity of the disease and the complications. All the bacterial strains were isolated after culturing the stool samples on differential culture media and the identification was performed respecting the standard laboratory methodology. The antibiotic sensitivity spectrum was determined using the API ATB G-5 tests for the following drugs: ampicillin, amoxicillin/clavulanate, ampicillin/sulbactam, trimethoprim/sulfamethoxazole, nalidixic acid, fluoroquinolones, tetracycline and third generation cephalosporins. Results During the studied period we identified 135 cases of acute Salmonella spp infection among hospitalized children, which stands for 8.5% of the total cases of acute diarrheal diseases. The most affected age group was the 1-4 years group, with a male predominance. The serotype distribution was: AO – 12.6%, BO – 31.1%, CO – 19.2% and DO – 37.1%. The chemosensitivity analysis revealed: 100% sensitivity to fluoroquinolones, carbapenems and third generation cephalosporins, 92.6% sensitivity to nalidixic acid and trimethoprim/sulfamethoxazole, 72.6% sensitivity to amoxicillin/clavulanate, ampicillin/sulbactam, 62.9% sensitivity to tetracycline and only 53.3% sensitivity to ampicillin.