title: An outbreak of antibiotic-resistant Salmonella enteritidis in Liberia, West Africa.
abstract: Between October 1980 and August 1982, 100 patients in the pediatric population at Curran Lutheran Hospital, Zorzor, Liberia were identified as having multiple drug-resistant Salmonella enteritidis serotype enteritidis. The illness usually presented as an enteric fever but also as meningitis, gastroenteritis, empyema, subcutaneous abscesses, chronic otitis media, or a combination of these conditions. Predisposing factors were young age and debilitation from malnutrition or measles. The mortality of infected patients was 27.8%. The organism was originally misidentified as a Citrobacter species because of a delayed reaction on lysine decarboxylase medium. Incubation of the medium for five days resulted in a positive reaction that identified the organism as a Salmonella species. The isolates were resistant to multiple antibiotics. Genes mediating resistance were located on a 120-megadalton conjugative plasmid. A cryptic nonconjugative 40-megadalton plasmid was also present in several isolates.
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000453:epidemiology*; D004352:Drug Resistance, Microbial; D006801:Humans; D007223:Infant; D007988:Liberia; D008826:Microbial Sensitivity Tests; D011815:R Factors; D012189:Retrospective Studies; D012480:Salmonella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D012477:Salmonella enteritidis / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification