Introduction Non-typhoidal salmonellosis (NTS) can cause invasive disease in special groups of children. Increasing antimicrobial resistance and limited epidemiological data pose major limitations to therapy. This study aims to analyse the disease characteristics in Singapore children.
Methods Retrospective cross- sectional study of children aged 0–16 years with invasive NTS over a 5-year period (January 2006–December 2011). Invasive NTS disease was defined as NTS species identified from normally sterile extra-intestinal sites ie. Blood and cerebrospinal fluid cultures.
Results There were 51 cases of which 22(43%) were female and 29(57%) were male. The median age at presentation was 15 months. 45(88.2%) patients were under 4 years and the youngest was 13 days old.
Fever and/or diarrhoea were most common presenting complaints. All had temperature > 38°C and 40 (78.4%) had diarrhoea with 19(47.5%) having bloody stools.
Mean initial total white cell count and C-reactive protein were 12.8 × 10^9/L and 64.2 mg/L respectively with Group D and B Salmonella species as the major isolates in 21(41.2%) and 17(33.3%). Group C accounted for 7(13.7%) while Group G / other non-typable ones contributed 6 (11.8%). Meningitis was confirmed in 3(5.9%). One child (1.9%) died of drug-related fulminant liver failure and there were no readmissions. Antibiotic resistance was noted in 16 (31.3%).
Conclusion There should be a high index of suspicion for NTS bacteremia in younger age group (≤4 years old) who present with fever and bloody diarrhoea. Initial inflammatory markers are not indicators of severity. Antimicrobial resistance in NTS in Singapore is low but needs vigilance.
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