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PubMed1995

[Failure of the treatment with antibiotics in severe Salmonella infections in children and use of quinolones].

BACKGROUND: Quinolone antibiotics are effective in the treatment of Salmonella infections in adults. Their use in children is limited by their side-effects. POPULATION AND METHODS: Forty-two patients (21 girls and 21 boys), aged 1 month to 12 years (mean 3.3 yrs) were admitted from September 1991 to June 1993 for severe Salmonella infections. Criteria of severity were persistent diarrhea and fever for more than 3 days. Thirty-one of these patients were less than 5 years of age. Blood culture was positive in 7 out of 35 patients: culture of the stools was positive in all patients. Five of the 42 patients had presented an acute episode of Salmonella infection a few weeks earlier and had remained asymptomatic carriers until the new acute and severe episode of diarrhea. All patients were given usual antibiotics, mainly ampicillin, amoxicillin, trimethoprime-sulfamethoxazole. Twenty-five of these patients were then given pefloxacin, 12 mg/kg/day, since the 5th day, for 7 days, because persistence of diarrhea and fever. RESULTS: Diarrhea and fever disappeared within less than 2 days in the group of patients given pefloxacin, even though in 6 patients the infecting Salmonella was in vitro resistant to beta-lactamins. Twenty % of patients remained asymptomatic carriers of Salmonella in the group treated by pefloxacin vs 47% in the group without it. There was no difference in species of Salmonella between both groups. None of the patients treated by pefloxacin developed side-effects during the six months following its administration. CONCLUSIONS: Short treatment by pefloxacin may be an alternative choice for treating severe Salmonella infections in children.

Amoxicillin↗
PubMed1989

Three unusual cases of Salmonella infection in infants.

Three unusual presentations of Salmonella infection in Asian infants in Nepal are described. Salmonella infections have protean manifestations and should be considered in the differential diagnosis of acute illness of obscure aetiology, especially in Salmonella-endemic areas.

Child, Preschool↗
PubMed2006

A case-control study of the epidemiology of sporadic Salmonella infection in infants.

OBJECTIVE: Rates of Salmonella infection are highest in infants, but little is known about potential sources of infection in this high-risk population. We performed a case-control study to identify dietary and environmental risk factors for sporadic salmonellosis among infants. PATIENTS AND METHODS: In 2002-2004, the Foodborne Diseases Active Surveillance Network conducted a population-based, case-control study of sporadic salmonellosis among infants <1 year of age in 8 states. Cases were identified via active laboratory-based surveillance. Healthy controls were frequency matched by age and identified through birth registries or published birth announcements. We assessed diet and environmental exposures in the 5 days before illness onset or interview. Data were analyzed by using logistic regression adjusting for age. RESULTS: The study enrolled 442 subjects and 928 controls. Compared with healthy controls, infants with Salmonella infection were less likely to have been breastfed and more likely to have had exposure to reptiles, to have ridden in a shopping cart next to meat or poultry, or to have consumed concentrated liquid infant formula during the 5-day exposure period. Travel outside the United States was associated with illness in infants 3 to 6 and >6 months of age. Attending day care with a child with diarrhea was associated with salmonellosis in infants >6 months of age. CONCLUSIONS: We identified a number of modifiable protective and risk factors for salmonellosis in infants. Attention should be directed at developing effective preventive measures for this high-risk population.

Case-Control Studies↗
PubMed1990

Dead salmonellae or their endotoxin accelerate the early course of a Salmonella infection in mice.

The course of a Salmonella infection following a low intravenous dose of virulent organisms was studied in mice. Simultaneous administration of 10(4) S. typhimurium C5 together with c. 10(8) dead salmonellae caused a marked acceleration of early net bacterial growth in the liver and spleen, leading to a rapidly overwhelming infection. Administration of similar numbers of either Staphylococcus albus or Bacillus cereus had no effect, whereas 20 micrograms of S. typhimurium Boivin-type lipopolysaccharide (B-LPS) produced an effect similar to dead organisms; 1 microgram B-LPS had a significant infection-accelerating effect. Both B-LPS and Westphal-type endotoxin (W-LPS) could enhance a salmonella infection in LPS-responsive C3H/HeMg mice, whereas only B-LPS was effective in LPS non-responder C3H/HeJ mice, implying that the infection-enhancing effect of a large bolus of dead organisms may be due in part to its LPS content. The results show that the course of a Salmonella infection following administration of large numbers of salmonellae in mice is different from that of Salmonella infections arising from small inocula. The relevance of these results to studies on the possible intracellular location of salmonellae in vivo is discussed.

Animals↗
PubMed2004

FoodNet estimate of the burden of illness caused by nontyphoidal Salmonella infections in the United States.

To determine the burden of Salmonella infections in the United States, Foodborne Diseases Active Surveillance Network (FoodNet) investigators conducted population-based active surveillance for culture-confirmed Salmonella infections during 1996-1999 at FoodNet laboratories. In addition, all clinical microbiology FoodNet laboratories were surveyed to determine their practices for isolating Salmonella. Telephone interviews were also conducted among residents of the FoodNet sites to determine the proportion of persons with diarrheal illness who sought medical care and the proportion who submitted stool specimens for bacterial culture. Using our model, we estimated that there were 1.4 million nontyphoidal Salmonella infections in the United States, resulting in 168,000 physician office visits per year during 1996-1999. Including both culture-confirmed infections and those not confirmed by culture, we estimated that Salmonella infections resulted in 15,000 hospitalizations and 400 deaths annually. These estimates indicate that salmonellosis presents a major ongoing burden to public health.

Campylobacter Infections↗
PubMed2005

[Salmonella infections in children: a retrospective study over a four-year period].

OBJECTIVES: Epidemiological state of salmonella infections in Languedoc-Roussillon (France) and discussion of therapeutic indications. MATERIAL AND METHOD: Retrospective study over a four-year period of paediatric salmonella infections requiring hospitalisation in Montpellier University Hospital. Analysis of clinical, bacteriological, laboratory and therapeutic data. RESULTS: One hundred and sixty nine cases of paediatric salmonella infections have been investigated. The clinical triad consisted of diarrhea, abdominal pain and fever. Six severe cases have been observed and seemed to have been independent of patient's background. Laboratory findings showed inconstantly hyperleucocytosis and increase in CRP levels. Stool analysis remained the reference laboratory test to detect salmonella. Two major strains of salmonella have been identified: Salmonella enterica subsp. enterica serovar Typhimurium and Enteriditis. Treatments have been essentially symptomatic but 20% of the children (n=34) required antibiotic therapy. A favourable outcome was observed in all the children. DISCUSSION: Incidence of salmonella infections is increasing in France, particularly in the Languedoc-Roussillon area. Diagnosis of mild forms is generally easy but certain patient background seems to expose to severe forms. Treatment of salmonella infections is mainly symptomatic, only severe or specific cases (young age, immunodepression...) requiring antibiotic treatment. The growing antibiotic use and the increasing of resistance are currently the main problems in the management of salmonella infections. Those infections remain a public health problem in Languedoc-Roussillon.

Adolescent↗
PubMed1982

Arthritis associated with salmonella infection.

Six cases of arthritis caused by or associated with Salmonella infection are reported. It is stated that an arthritis associated with a Salmonella infection cannot be excluded on the negative results of the Widal test. Consequent upon Salmonella infection two different types of arthritis might develop: a) monoarticular infectious arthritis or b) a subacute reactive oligo-articular arthritis. In this study a patient with a chronic destructive "reactive" oligoarthritis is described, resembling experimental "Salmonella-associated arthritis" in rats. This form of arthritis might be regarded as an immune complex mediated disease associated with a chronic infection.

Adult↗
PubMed1985

Local transfer of delayed-type hypersensitivity after Salmonella infection in mice.

An adoptive local transfer system has been used to study the mediators of delayed-type hypersensitivity induced in mice by infection with Salmonella enteritidis 11RX. The cells which transfer this state of hypersensitivity to untreated recipients are nonadherent T lymphocytes with the surface phenotype Lyt 1+2-, and successful transfer requires compatibility at the I-A subregion of the H-2 complex. In these and other respects these cells are indistinguishable from those previously found to be responsible for in vitro lymphokine release upon culture with 11RX antigens.

Animals↗
PubMed1990

Salmonella infection in total hip replacement: tests to predict the outcome of antimicrobial therapy.

We report a hematogenous implant infection with Salmonella dublin in a renal transplant patient with total hip replacement. A 16-month treatment with cotrimoxazole failed, as evidenced by culture and electron microscopy, despite persisting low MIC after therapy. Data from a foreign body animal model and in vitro tests, which take into account the properties of adhering and stationary-phase bacteria, explain the failure of a long-term treatment with cotrimoxazole. The patient was subsequently cured by ciprofloxacin which was successful in these tests. No relapse was noted after a follow-up of 1 year.

Adult↗
PubMed1990

[Salmonella infections in infants under 1 year of age].

As many as 76 children of the first year of life suffering from salmonellosis were examined for the clinical manifestations of the disease and for the immune status. The data were obtained, pointing to the development of secondary immuno- and granulocytopathies influencing the course the disease takes.

Age Factors↗
PubMed2001

Evaluation of subtherapeutic use of the antibiotics apramycin and carbadox on the prevalence of antimicrobial-resistant Salmonella infection in swine.

The antibiotics apramycin and carbadox were fed to growing swine, and the prevalence of Salmonella isolates that are resistant to apramycin and related aminoglycoside antibiotics was examined. Three hundred twelve Salmonella-positive pigs raised on one of five farms in an integrated swine operation and slaughtered at a central plant were used. All farms fed carbadox during the grower phase, and two farms administered apramycin during the first 21 days of age. Ileocolic lymph nodes and cecal contents were sampled at slaughter. One hundred of the 312 pigs were randomly selected to examine apramycin- and carbadox-resistant Salmonella infection, while all 312 pigs were used to evaluate the association between apramycin exposure and infection with Salmonella organisms resistant to amikacin, gentamicin, kanamycin, and streptomycin. Antimicrobial resistance was determined using disk diffusion and breakpoint concentrations. Apramycin treatment appeared to have little effect on apramycin- (12.5 versus 20.9%) or streptomycin- (76.4 versus 73.5%) resistant Salmonella isolates when averaged across farms and compared to control animals. Feeding carbadox resulted in carbadox-resistant Salmonella infection in only 5.3% of the isolates on one farm. The prevalence of amikacin-, gentamicin-, and kanamycin-resistant Salmonella isolates on farms feeding apramycin and carbadox were 0, 0, and 1.8%, respectively. Serogroup B was the most prevalent serogroup isolated, followed by C1 and E1. Apramycin and carbadox treatment did not appear to have any effect on the serogroup isolated. Subtherapeutic use of carbadox and apramycin did not appear to increase the prevalence of antimicrobial-resistant Salmonella in market-age swine.

Animals↗
PubMed2000

Modification of disease outcome in Salmonella-infected patients by HLA-B27.

OBJECTIVE: To study whether HLA-B27 modifies the outcome of Salmonella infection in vivo. METHODS: The frequency of HLA-B27 was determined in 198 Salmonella-infected patients and 100 healthy controls by immunofluorescence and polymerase chain reaction. The excretion of Salmonella was monitored at monthly intervals. The symptoms of acute infection and possible joint involvement were evaluated using questionnaires. RESULTS: Thirty-eight of 198 Salmonella-infected patients (19.2%) and 13 of 100 healthy controls (13.0%) were HLA-B27 positive. The excretion of Salmonella did not differ significantly between HLA-B27-positive and -negative patients, or for patients with versus those without joint symptoms. As many as 35 patients (17.7%) reported Salmonella-triggered joint symptoms. Three of 14 patients (21.4%) with arthralgia, 5 of 13 patients (38.5%) with probable reactive arthritis (ReA), and 6 of 8 patients (75%) with confirmed ReA were HLA-B27 positive. The duration and severity of joint symptoms directly correlated with HLA-B27 positivity. Women reported Salmonella-induced pain and swelling of joints more frequently than men (P = 0.07 and P = 0.03, respectively). Patients with Salmonella-triggered joint symptoms reported abdominal pain and headache more frequently than patients without joint symptoms (P = 0.05 and P = 0.004, respectively). CONCLUSION: HLA-B27 did not (at least, not strongly) confer susceptibility to Salmonella infection. Salmonella excretion correlated neither with HLA-B27 positivity nor with the occurrence of joint symptoms. Joint symptoms were surprisingly common during or after Salmonella infection. HLA-B27-positive patients had a significantly increased risk of developing joint and tendon symptoms. Moreover, HLA-B27 positivity correlated with the development of more severe and prolonged joint symptoms.

Adolescent↗
PubMed1993

[Control of salmonella infections in animal herds--basis for a reduction of salmonella entries into food].

Control measures against Salmonella infections in livestock are discussed on the basis of an epidemiological classification of Salmonella serovars important for animals and/or humans. Special attention is paid to immunoprophylaxis carried out additionally to generally accepted zoo sanitary measures. Available Salmonella vaccines are described and their major characteristics discussed briefly. Schemes are presented for the administration of vaccines in cattle, pigs and poultry. They have to be rationally integrated into general control concepts. They should serve as recommendations for the practical use in animal farms. It is concluded that given consequent combination and enforcement of the described measures the occurrence of Salmonella serovars important for animals and/or humans can be reduced decisively in livestock, thus minimizing introduction into the food chain for the sake of improved consumer protection.

Animals↗
PubMed2004

Release kinetics and cell trafficking in relation to bacterial growth explain the time course of blood neutrophils and monocytes during primary Salmonella infection.

Granulocytes and neutrophils are predominantly responding cells during the early phase of infection of rats with Salmonella. We propose mathematical and experimental models of the kinetics of neutrophil and monocyte responses in Salmonella infection via the oral route. Using the models, we estimate that approximately 1 in 500 inoculated Salmonella cells actually infected the rat and multiplied with a doubling time of 5 h in Peyer's patches, reaching a maximum of approximately 10(6) c.f.u./g. In low-dose infection, neutrophil and monocyte responses are delayed, but further resemble the responses in high-dose infection. Important processes influencing neutrophil and monocyte recruitment are: massive migration into the infected tissue, and non-linear release kinetics of neutrophils and monocytes from the bone marrow. In conclusion, we can predict time series of neutrophil and monocyte responses in low-dose and high-dose experimental infection via the oral route.

Animals↗