A Systematic Review of the Diagnosis and Treatment of Non-Typhoid Salmonella Spondylodiscitis in Immunocompetent Children

Abstract

The aim of this systematic review is to distinguish the clinical features of immunocompetent children with non-typhoid Salmonella spondylodiscitis and summarize the diagnosis, diagnostic tools, and treatment methods to guide clinicians. The review was conducted according to the preferred PRISMA guidelines. We conducted a literature search in the PubMed, Embase, and Cochrane Library databases. Article screening, data extraction, and study evaluation were performed by two independent reviewers. A total of 20 articles, published between 1977 and 2020, were selected, which included 21 patients with average age of 12.76 years (range, 2–18) without comorbidities; in total, 19% of the patients had positive blood cultures for non-typhoid Salmonella, and 80.9% underwent either CT-guided or open biopsy, which were positive for NTS. All infections were monomicrobial, and 11 different serotypes of non-typhoid Salmonella were identified. Analyzing the reviewed cases, 52.4% of the patients presented with fever, 90.5% had localized pain, and only 19% had gastroenteritis. The most common level of discitis was the lumbar region, especially the L4/L5 level. Primarily, third-generation cephalosporin was administered, and antibiotic treatment was given for an average of 9.6 weeks. Non-typhoid Salmonella spondylodiscitis is a rare clinical entity in healthy and immunocompetent children. The identification of the responsible organism is essential to guide antibiotic therapy and define the treatment duration. A significant limiting factor in this systematic review was the lack of published research articles and case series due to the rarity of the disease.

An Atypical Case of Spondylitis Due to Nontyphoidal Salmonella in an Adult Patient: A Case Report and Review of the Literature

“…Both types can lead to systemic infections that rarely escalate to osteomyelitis [ 3 ]. Of these, an even smaller fraction culminates in spondylitis [ 2 ]. Several studies have explored spondylitis caused by typhoidal Salmonella and described its clinical characteristics [ 4 ].…”

“…Correspondingly, there have been reviews examining spondylitis caused by nontyphoidal Salmonella spp. in children [ 2 ], delineating typical clinical presentations. However, although there are 21 case reports of spondylitis due to nontyphoidal Salmonella in adults published in English on PubMed, comprehensive reviews of its clinical features are lacking [ 5 - 25 ].…”

“…Nontyphoidal Salmonella primarily causes enteric infections, although spondylitis, an infrequent complication, has also been documented [ 1 ]. A comprehensive review of the clinical features of spondylitis induced by nontyphoidal Salmonella in children has been published [ 2 ] and multiple case reports have documented spondylitis induced by nontyphoidal Salmonella in adults; however, no comprehensive review encompassing the clinical features exists in the literature currently. Historically, localized pain (in the chest, back, or lumbar region) is observed in most cases of spondylitis caused by nontyphoidal Salmonella.…”

Antibiotic Resistance Profile of Salmonella sp. Isolates from Commercial Laying Hen Farms in Central-Western Brazil

“…The indiscriminate use of antibiotics in human and animal healthcare, as well as in food production, coupled with their subsequent release into the environment, contribute to the emergence of antibiotic-resistant Salmonella strains [40]. Understanding the link between antibiotic resistance and the presence of resistance genes in Salmonella strains is crucial and warrants continuous investigation [17,19,22,26,41]. Contaminated poultry products represent the primary transmission vector for Salmonella.…”

“…However, the food chain is also a critical vector for the spread of antibiotic resistance from animals to humans. The rise of antibiotic resistance in non-typhoidal Salmonella strains poses a significant public health risk [24][25][26], underscoring the importance of monitoring resistance profiles in Salmonella Typhimurium and Salmonella Enteritidis. This not only aids in disease management but also helps track the development of potential multidrug-resistant strains.…”