Report of data on children with non-typhi Salmonella gastroenteritis in a three-year period.
The purpose of this study was to evaluate the clinical and laboratory data of children with acute gastroenteritis caused by non-typhoid Salmonella spp. infections. Clinical (demographic data, symptoms and findings) and laboratory data (stool microscopy, rapid antigen tests, culture, multiplex polymerase chain reaction and blood test results) of children with acute gastroenteritis caused by non-typhoid Salmonella spp. between January 2010 and October 2012 were evaluated. Differences between the groups for categorical variables were estimated with a chi-square or Fisher exact test; for continuous variables with two independent samples a t test was used. P values < 0.05 were considered statistically significant. Sixty-seven children, 39 (58.2%) males and 28 (41.8%) females aged between 1 - 16 years (mean ± SD: 4.64 ± 2.91), were diagnosed with acute bacterial gastroenteritis caused by non-typhoid Salmonella spp. The main serotypes are Salmonella enteritidis (85%) and Salmonella typhimurium (7.5%). The presenting symptoms were diarrhoea (95.5%), fever (61.1%), vomiting (34.3%), abdominal pain (32.8%), loss of appetite (7.4%) and malaise (7.4%). Fever and dehydration (moderate and/or severe) were detected in 11 (16.4%) patients. The mean leukocyte count was 10.930/μL [95% confidence interval (CI), SD: ± 5.710/μL], neutrophil count was 7.880/μL (95% CI, SD: ± 4.960/μL), CRP was 64.16 mg/L (95% CI, SD: ± 76.24 mg/L), and erythrocyte sedimentation rate was 34.72 mm/hour (95% CI, SD: ± 13.64 mm/h). Stool microscopy was positive for leukocytes in 18 patients (26.8%). The definitive diagnosis was made with positive stool culture (n = 65) and/or PCR test (n = 4). Viral antigen positivity was detected in 10 patients (14.9%), evaluated as viral co-infection and false positive results. Antibiotic therapy and hospitalization were required in 26 (38.8%) and 23 (34.3%) patients, respectively. Salmonella carriage was detected in one patient (1.5%). Bloody diarrhoea, leukocytes in stool with an increased erythrocyte sedimentation rate and a CRP level without overt leukocytosis may indicate Salmonella infection. Viral antigens may cause false positive results in fast antigen tests in cases where clinical and laboratory findings indicate bacterial aetiology. Stool culture is a reference method in diagnosis whereas some agents may be detected via molecular techniques (polymerase chain reaction) in spite of negative culture. Multiplex polymerase chain reaction may be used to detect Salmonella spp. and may reveal false positivity for viruses as well as the detection of other bacteria.
Department of Child Health and Paediatrics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Öznur
Ö
Küçük
Department of Child Health and Paediatrics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Suat
S
Biçer
Department of Child Health and Paediatrics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Meltem
M
Ugraş
Department of Child Health and Paediatrics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Defne
D
Çöl
Department of Child Health and Paediatrics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Tuba
T
Giray
Department of Child Health and Paediatrics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Gülay
G
Çiler Erdag
Department of Medical Microbiology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Yeşim
Y
Gürol
Department of Medical Microbiology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Gülden
G
Yilmaz
Department of Child Health and Paediatrics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Zerrin
Z
Yalvaç
Department of Child Health and Paediatrics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Ayça
A
Vitrinel
Department of Medical Statistics and Informatics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Çigdem
Ç
Kaspar
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D060085:Coinfection; D019353:Endemic Diseases; D005189:False Positive Reactions; D005243:Feces / Q000382:microbiology; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D012478:Salmonella Food Poisoning / Q000453:epidemiology / Q000382:microbiology; D012480:Salmonella Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D012477:Salmonella enteritidis / Q000302:isolation & purification; D012486:Salmonella typhimurium / Q000302:isolation & purification; D012621:Seasons; D063189:Symptom Assessment; D014421:Turkey / Q000453:epidemiology; D014777:Virus Diseases / Q000150:complications; D014876:Water Pollution / Q000009:adverse effects