Non-typhoidal Salmonella infections among children in a tertiary hospital in Ningbo, Zhejiang, China, 2012–2019

Ke, Yefang; Wen-bo, LU; Liu, Wenyuan; Zhu, Ping; Chen, Qunying; Zhu, Zhe

doi:10.1371/journal.pntd.0008732

Cited by 30 publications

(33 citation statements)

References 59 publications

(99 reference statements)

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“…In the present study, low level of resistance towards fluoroquinolones (3.92% for ciprofloxacin and 0 for levofloxacin) were observed, which was inconsistent with the findings previously reported in some studies in Uganda and Japan (Kobayashi et al, 2014;Ota et al, 2016). This may be due to the fact that 90.38% (47/52) NTS strains isolated from children aged ≤ 5 years in this study, fluoroquinolones were rarely used in children due to articular toxicity (Ke et al, 2020). Similarly, in a study conducted in China, the prevalence of resistance to ciprofloxacin among NTS isolates was 8.05% (147/1826), and children aged <5 years accounted for 73% (1329/1826) of the overall NTS infections (Liang et al, 2015).…”

Section: Discussioncontrasting

confidence: 99%

Prevalence, Serotype Distribution and Antimicrobial Resistance of Non-Typhoidal Salmonella in Hospitalized Patients in Conghua District of Guangzhou, China

Gong

Hong

Feng

et al. 2022

Front. Cell. Infect. Microbiol.

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Salmonella infection is a major public health concern worldwide, has contributed to an increased economic burden on the health systems. Non-typhoidal Salmonella (NTS) is a common cause of bacterial enteritis in humans, causing 93.8 million cases of gastroenteritis globally each year, with 155,000 deaths. Guangzhou city is situated in the south of China and has a sub-tropical climate, the heat and heavy rainfall helps the spread of NTS. However, no information of NTS infection is available in humans in Conghua District, the largest administrative district of Guangzhou. To understand the prevalence, serotype distribution, risk factors and drug resistance of NTS infection in humans in the survey area, an epidemiological investigation was conducted in hospitalized patients in Conghua District in Guangzhou, China. A total of 255 fecal specimens were collected from hospitalized patients (one each), with a questionnaire for each participant, and NTS infection was identified by culture, as well as serotypes confirmed by slide agglutination tests. An average prevalence of 20.39% (52/255) was observed and three serogroups were identified—serogroup B (n = 46), serogroup C1 (n = 4) and serogroup D1 (n = 2). Among them, Salmonella Typhimurium (n = 39) was the most common serotype. Children aged <3 years were observed to have a statistically higher prevalence of NTS infection than adults (25.15% versus 4.65%, P = 0.006); children with artificial feeding had a statistically higher prevalence than those with breastfeeding (30.77% versus 8.33%, P = 0.044). Antimicrobial resistance testing revealed that the majority of strains were resistant to ampicillin (92.16%), as well as 47.06% of all strains were multi-drug resistant. Therefore, it is necessary to continuous monitoring and rational use of antibiotics, which will be helpful to reduce the prevalence of resistant strains. These data will aid in making efficient control strategies to intervene with and prevent occurrence of salmonellosis.

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Section: Discussioncontrasting

confidence: 99%

Prevalence, Serotype Distribution and Antimicrobial Resistance of Non-Typhoidal Salmonella in Hospitalized Patients in Conghua District of Guangzhou, China

Gong

Hong

Feng

et al. 2022

Front. Cell. Infect. Microbiol.

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“…On the basis of the current findings, we recommend against routinely using antimicrobials to treat uncomplicated NTS gastroenteritis in cases of high CRP level. This finding is consistent with that of Mughini-Gras et al (2020) who reported that iNTS isolates were generally less resistant than non-iNTS isolates (Mughini-Gras et al, 2020;Ke et al, 2020). NTS bacteremia in this study tended to develop in young children with prolonged fever.…”

Section: Discussionsupporting

confidence: 92%

“…Approximately 5% of individuals with NTS infection develop invasive diseases, such as bacteremia, meningitis, or septic arthritis, which are especially common in young infants or patients with compromised immune systems ( Hohmann, 2001 ; Feasey et al, 2012 ). Antimicrobial agents are not recommended for non-severe NTS diarrhea, but they are recommended for people at risk of severe or invasive infection ( Ke et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Changing Antimicrobial Resistance and Epidemiology of Non-Typhoidal Salmonella Infection in Taiwanese Children

Chang

Chen

et al. 2021

Front. Microbiol.

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Non-typhoidal Salmonella (NTS) typically causes self-limiting diarrheal disease but may occasionally lead to invasive infection. This study investigated the epidemiology and antimicrobial resistance of children with NTS infection between 2012 and 2019. We retrospectively analyzed pediatric patients with NTS infections, confirmed by positive cultures, in a tertiary medical center in Taiwan in 2012 and 2019. Clinical features and laboratory data of the patients were collected. Changes in the serogroup category and antimicrobial resistance were also analyzed. Of the total 797 isolates collected, 55 had NTS bacteremia. Compared with the resistance rates in 2012, the rates of resistances to third-generation cephalosporin and ciprofloxacin were significantly higher in 2019 (4.1% vs 14.3%, P < 0.001; 1.9% vs 28.6%, P < 0.001), especially in groups B, D, and E. Moreover, we observed significantly higher antimicrobial resistance (25.3%) to third-generation cephalosporin, and approximately half the NTS isolates in the infant group were multidrug resistant – a higher rate than those of other age groups in 2019. Invasive NTS often presented with a longer fever duration, lower hemoglobin level and with no elevated C-reactive protein (P < 0.05). Non-invasive NTS isolates in 2019 were significantly more resistant to ceftriaxone (P < 0.001) and ciprofloxacin (P < 0.001) than those in 2012. The antimicrobial resistance of NTS in children has increased progressively in the past decade, and different serogroups exhibited different resistance patterns. During this period, infants showed the highest risk to get a third-generation cephalosporin-resistant NTS infection. The high rates of antimicrobial resistance among children with NTS in Taiwan merit continual surveillance.

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“…Furthermore, S. Typhimurium (Group B) and S. Enteritidis (Group D) infections showed the same trend, which was similar to the result of another previous study. 22 However, S. Typhimurium remains the most prevalent serotype, and its prevalence rises annually; many reports are in concordance with our findings, such as those in Ningbo, Zhejiang, China, 23 southern India, 24 Africa, 25 Australia, 16 Thailand and Laos provinces. 26 However, studies from Shanghai, China, 27 and the United States 28 reported that S. Enteritidis was more common than S. Typhimurium.…”

supporting

confidence: 91%

Epidemiology, Serotype and Resistance of Salmonella Isolates from a Children’s Hospital in Hangzhou, Zhejiang, China, 2006–2021

Yue¹,

Liu²,

Li³

et al. 2022

IDR

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This research investigated the dynamics of antibiotic resistance in Salmonella and the epidemiology of Salmonella infection in children. These data can aid in the prevention and control of the Salmonella epidemic and the diagnosis and treatment of salmonellosis. Methods: In this study, we retrospectively reviewed and analysed data regarding epidemiology, clinical symptoms, Salmonella serotypes, and antibiotic resistance from the medical records of patients with Salmonella infections in Hangzhou Children's Hospital from April 2006 to December 2021. Results: A total of 2099 Salmonella isolates were identified during the 16-year study period, and 98.6% (2069) of the isolates were isolated from stool. About 84.5% (1773/2099) of the total Salmonella isolates were detected from May to October. The median age of the 2099 children with Salmonella infection was 1.4 years (17 months) (IQR: 0.9-2.8 years). In 1572 (74.9%) patients, the course of the disease was limited to uncomplicated gastroenteritis. S. Typhimurium (805/2099, 38.4%) was predominant, followed by S. Enteritidis (290/2099, 13.8%). The total number of serotypes and the number of less common serotypes are increasing. Nontyphoid Salmonella that cause invasive infections, including S. Typhimurium, S. Stanley, and S. Choleraesuis, accounted for 60.0% (18/30). The Salmonella strains were resistant to ampicillin, ampicillin-sulbactam, trimethoprim-sulfamethoxazole, ceftriaxone, and ciprofloxacin at percentages of 71.5%, 51.5%, 36.5%, 22.4%, and 14.7%, respectively. No imipenem-resistant strains were identified. 24.8% of the isolates exhibited multidrug resistance (MDR). Conclusion: S. typhimurium and S. enteritidis were the dominant serotypes in children (<2 years) with salmonella-infected arrhoea in Hangzhou, China. Ongoing serotype monitoring should be necessitated and dynamic changes in serotypes should be carefully examined to prevent the sudden outbreak of foodborne illness. Salmonella exhibits a higher rate of resistance to common antibiotics, and the risk of multidrug resistance should not be ignored. Therefore, clinicians should administer antibiotics judiciously according to the results of drug sensitivity tests.

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Non-typhoidal Salmonella infections among children in a tertiary hospital in Ningbo, Zhejiang, China, 2012–2019

Cited by 30 publications

References 59 publications

Prevalence, Serotype Distribution and Antimicrobial Resistance of Non-Typhoidal Salmonella in Hospitalized Patients in Conghua District of Guangzhou, China

Prevalence, Serotype Distribution and Antimicrobial Resistance of Non-Typhoidal Salmonella in Hospitalized Patients in Conghua District of Guangzhou, China

Changing Antimicrobial Resistance and Epidemiology of Non-Typhoidal Salmonella Infection in Taiwanese Children

Epidemiology, Serotype and Resistance of Salmonella Isolates from a Children’s Hospital in Hangzhou, Zhejiang, China, 2006–2021

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