title: Decreasing prevalence of antimicrobial resistance in non-typhoidal Salmonella isolated from children with bacteraemia in a rural district hospital, Kenya.
abstract: We analysed 336 non-typhoidal Salmonella (NTS) isolated from children <13 years of age with bacteraemia admitted to a rural district hospital in Kenya from 1994 to 2005. Pulsed-field gel electrophoresis was used to determine genetic relatedness of strains, and antimicrobial susceptibility testing was also performed. Most NTS were either Salmonella enterica serovar Typhimurium (n=114; 33.9%) or S. enterica serovar Enteritidis (n=128; 38.1%), with minimal genotypic diversity over the study period. The NTS showed a remarkable decrease in levels of resistance especially to two commonly available antimicrobials (amoxicillin and co-trimoxazole), from high of 69.2% and 68.4% during 1994-1997 to 11% and 13%, respectively, in 2002-2005 (P<0.01). All NTS remained fully susceptible to cefotaxime and ciprofloxacin. Our findings show that commonly available drugs may still be useful for treatment of invasive NTS infections in this rural population.
authors.affiliation: Centre for Microbiology Research, Kenyatta National Hospital, P.O. Box 20723, Nairobi, Kenya. skariuki@kemri.org
authors.forename: Samuel
authors.initials: S
authors.lastname: Kariuki
authors.forename: Gunturu
authors.initials: G
authors.lastname: Revathi
authors.forename: John
authors.initials: J
authors.lastname: Kiiru
authors.forename: Brett
authors.initials: B
authors.lastname: Lowe
authors.forename: James A
authors.initials: JA
authors.lastname: Berkley
authors.forename: C Anthony
authors.initials: CA
authors.lastname: Hart
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000097:blood / Q000134:cerebrospinal fluid / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006780:Hospitals, Rural; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya; D008826:Microbial Sensitivity Tests; D012475:Salmonella / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D012480:Salmonella Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000382:microbiology*; D019779:Salmonella enterica / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents