Salmonella typhimurium outbreak in a neonatal unit in Turkey.
OBJECTIVE
To analyze an outbreak caused by a multiple resistant strain of S. typhimurium in a newborn unit in Turkey.


METHODS
The outbreak occurred during the period 15 to 29 March,2005. A newborn infected with S. typhimurium was defined as a case. Newborns who were hospitalized during the outbreak period with no diagnosis of S. typhimurium infections (n=50) constituted the control group I (CG I). The matched patients of the control group II (CG II) (n=20) were selected from neonates without S. typhimurium infections during the period.


RESULTS
Of 22 infants who were affected two died. Cases developed diarrhea (n=20), septicemia (n=5) and meningitis (n=1). The strain was resistant to ampicillin, ceftriaxone, ceftazidime, amikacin, trimethoprim-sulfamethoxasole and chloramphenicol, susceptible to meropenem. All of the infected neonates were treated with meropenem. The surveillance cultures were negative. The outbreak was controlled by appropriate therapy and institution of effective control measures. The cases were more exposed to mechanical ventilation than CG I (p<0.05). The mean additional length of stay in cases was significantly different from CG II (14.9 days vs. 5.1 days, p<0.05). The mean charges was $1588.78 for a case and $506.94 for a control (P<0.05). Accommodation accounted for 44.5% of these extra charges.


CONCLUSIONS
This study increases the understanding of the burden of multidrug-resistant S. typhimurium infection. Nosocomial outbreaks have a major effect on healthcare delivery, costs and outcomes.
Anil
Murat
M
Department of Pediatrics, Tepecik Educational and Research Hospital, Izmir, Turkey. muratanil1969@hotmail.com
Helvaci
Mehmet
M
Ozkalay
Nisel
N
Toprak
Esra
E
Anil
Ayse Berna
AB
Dilek
Mustafa
M
Agus
Neval
N
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology*; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D000077731:Meropenem; D012480:Salmonella Infections / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology*; D012486:Salmonella typhimurium / Q000187:drug effects; D013845:Thienamycins / Q000627:therapeutic use; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D013845:Thienamycins; D000077731:Meropenem