BACKGROUND: Nontyphoidal Salmonella (NTS), mainly serotypes Typhimurium and Enteritidis, cause invasive infections with high mortality in children in sub-Saharan Africa. Multidrug resistance is common, and resistance to third-generation cephalosporins has emerged. METHODS: We reviewed clinical features, outcomes, and antimicrobial resistance patterns in invasive NTS infections among children aged 6 weeks to 5 years participating in malaria vaccine studies in an area of high malaria and human immunodeficiency virus (HIV) transmission in Siaya, western Kenya. Blood culture was performed in hospitalized children and pediatric outpatients with prolonged fever. RESULTS: From July 2009 to December 2013, 1696 children aged 6 weeks to 17 months were enrolled into vaccine trials and followed for up to 53 months. We obtained 1692 blood cultures from 847 children. Of 134 bacterial pathogens isolated, 102 (76.1%) were Salmonella serogroup B or D. Invasive NTS disease occurred in 94 (5.5%) children, with an incidence of 1870, 4134, and 6510 episodes per 100 000 person-years overall, in infants, and in HIV-infected children, respectively. Malaria infection within the past 2 weeks occurred in 18.8% (3/16) of invasive NTS episodes in HIV-infected and 66.2% (53/80) in HIV-uninfected children. Case fatality rate was 3.1%. Salmonella group B resistant to ceftriaxone emerged in 2009 and 2010 (6.2% [2/32 isolates]), rising to 56.5% (13/23 isolates) in 2012 and 2013. CONCLUSIONS: Incidence of invasive NTS disease was high in this area of high malaria and HIV transmission, especially in HIV-infected children. Rapidly emerging resistance against ceftriaxone requires urgent reevaluation of antibiotic recommendations and primary prevention of exposure to Salmonella.
BACKGROUND:Nontyphoidal Salmonella (NTS), mainly serotypes Typhimurium and Enteritidis, cause invasive infections with high mortality in children in sub-Saharan Africa. Multidrug resistance is common, and resistance to third-generation cephalosporins has emerged. METHODS: We reviewed clinical features, outcomes, and antimicrobial resistance patterns in invasive NTS infections among children aged 6 weeks to 5 years participating in malaria vaccine studies in an area of high malaria and human immunodeficiency virus (HIV) transmission in Siaya, western Kenya. Blood culture was performed in hospitalized children and pediatric outpatients with prolonged fever. RESULTS: From July 2009 to December 2013, 1696 children aged 6 weeks to 17 months were enrolled into vaccine trials and followed for up to 53 months. We obtained 1692 blood cultures from 847 children. Of 134 bacterial pathogens isolated, 102 (76.1%) were Salmonella serogroup B or D. Invasive NTS disease occurred in 94 (5.5%) children, with an incidence of 1870, 4134, and 6510 episodes per 100 000 person-years overall, in infants, and in HIV-infectedchildren, respectively. Malaria infection within the past 2 weeks occurred in 18.8% (3/16) of invasive NTS episodes in HIV-infected and 66.2% (53/80) in HIV-uninfectedchildren. Case fatality rate was 3.1%. Salmonella group B resistant to ceftriaxone emerged in 2009 and 2010 (6.2% [2/32 isolates]), rising to 56.5% (13/23 isolates) in 2012 and 2013. CONCLUSIONS: Incidence of invasive NTS disease was high in this area of high malaria and HIV transmission, especially in HIV-infectedchildren. Rapidly emerging resistance against ceftriaxone requires urgent reevaluation of antibiotic recommendations and primary prevention of exposure to Salmonella.
Authors: Kyaw Thu Aung; Wei Ching Khor; Kar Hui Ong; Wei Ling Tan; Zhi Ning Wong; Jia Quan Oh; Wai Kwan Wong; Brian Zi Yan Tan; Matthias Maiwald; Nancy Wen Sim Tee; Timothy Barkham; Tse Hsien Koh; Anders Dalsgaard; Swaine L Chen; Joergen Schlundt; Lee Ching Ng Journal: Int J Environ Res Public Health Date: 2022-05-06 Impact factor: 4.614
Authors: Heidi Hopkins; Katia J Bruxvoort; Matthew E Cairns; Clare I R Chandler; Baptiste Leurent; Evelyn K Ansah; Frank Baiden; Kimberly A Baltzell; Anders Björkman; Helen E D Burchett; Siân E Clarke; Deborah D DiLiberto; Kristina Elfving; Catherine Goodman; Kristian S Hansen; S Patrick Kachur; Sham Lal; David G Lalloo; Toby Leslie; Pascal Magnussen; Lindsay Mangham Jefferies; Andreas Mårtensson; Ismail Mayan; Anthony K Mbonye; Mwinyi I Msellem; Obinna E Onwujekwe; Seth Owusu-Agyei; Hugh Reyburn; Mark W Rowland; Delér Shakely; Lasse S Vestergaard; Jayne Webster; Virginia L Wiseman; Shunmay Yeung; David Schellenberg; Sarah G Staedke; Christopher J M Whitty Journal: BMJ Date: 2017-03-29
Authors: Jessica Z Kubicek-Sutherland; Dung M Vu; Aneesa Noormohamed; Heather M Mendez; Loreen R Stromberg; Christine A Pedersen; Astrid C Hengartner; Katja E Klosterman; Haley A Bridgewater; Vincent Otieno; Qiuying Cheng; Samuel B Anyona; Collins Ouma; Evans Raballah; Douglas J Perkins; Benjamin H McMahon; Harshini Mukundan Journal: Sci Rep Date: 2019-04-17 Impact factor: 4.379
Authors: Calman A MacLennan; Chisomo L Msefula; Esther N Gondwe; James J Gilchrist; Paul Pensulo; Wilson L Mandala; Grace Mwimaniwa; Meraby Banda; Julia Kenny; Lorna K Wilson; Amos Phiri; Jenny M MacLennan; Elizabeth M Molyneux; Malcolm E Molyneux; Stephen M Graham Journal: PLoS Negl Trop Dis Date: 2017-12-07