Characterisation of community acquired non-typhoidal Salmonella from bacteraemia and diarrhoeal infections in children admitted to hospital in Nairobi, Kenya
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作者:
Kariuki, Samuel
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Kenya Govt Med Res Ctr, Ctr Microbiol Res, Nairobi, KenyaKenya Govt Med Res Ctr, Ctr Microbiol Res, Nairobi, Kenya
Kariuki, Samuel
[1
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Revathi, Gunturu
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机构:Kenya Govt Med Res Ctr, Ctr Microbiol Res, Nairobi, Kenya
Revathi, Gunturu
Kariuki, Nyambura
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机构:Kenya Govt Med Res Ctr, Ctr Microbiol Res, Nairobi, Kenya
Kariuki, Nyambura
Kiiru, John
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机构:Kenya Govt Med Res Ctr, Ctr Microbiol Res, Nairobi, Kenya
Kiiru, John
Mwituria, Joyce
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机构:Kenya Govt Med Res Ctr, Ctr Microbiol Res, Nairobi, Kenya
Mwituria, Joyce
Hart, Charles A.
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机构:Kenya Govt Med Res Ctr, Ctr Microbiol Res, Nairobi, Kenya
Hart, Charles A.
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[1] Kenya Govt Med Res Ctr, Ctr Microbiol Res, Nairobi, Kenya
[2] Kenyatta Natl Hosp, Dept Med Microbiol, Nairobi, Kenya
[3] Univ Nairobi, Dept Paediat & Child Hlth, Nairobi, Kenya
[4] Univ Liverpool, Dept Med Microbiol & Genitourinary Med, Liverpool L69 3BX, Merseyside, England
Background: In sub-Saharan Africa community-acquired non-typhoidal Salmonella ( NTS) is a major cause of high morbidity and death among children under 5 years of age especially from resource poor settings. The emergence of multidrug resistance is a major challenge in treatment of life threatening invasive NTS infections in these settings. Results: Overall 170 ( 51.2%) of children presented with bacteraemia alone, 28 ( 8.4%) with gastroenteritis and bacteraemia and 134 ( 40.4%) with gastroenteritis alone. NTS serotypes obtained from all the cases included S. Typhimurium ( 196; 59%), S. Enteritidis ( 94; 28.3%) and other serotypes in smaller numbers ( 42; 12.7%); distribution of these serotypes among cases with bacteremia or gastroenteritis was not significantly different. A significantly higher proportion of younger children (< 3 years of age) and those from the slums presented with invasive NTS compared to older children and those from upper socio- economic groups ( p < 0.001). One hundred and forty- seven ( 44.3%) NTS were resistant to 3 or more antibiotics, and out of these 59% were resistant to ampicillin, chloramphenicol and tetracycline. There was no significant difference in antibiotic resistance between the two serotypes, S. Typhimurium and S. Enteritidis. Ceftriaxone and ciprofloxacin were the only antibiotics tested to which all the NTS were fully susceptible. Using Pulsed Field Gel Electrophoresis ( PFGE) there were 3 main patterns of S. Typhimurium and 2 main patterns of S. Enteritidis among cases of bacteraemia and gastroenteritis. Conclusion: Serotype distribution, antibiotic susceptibility and PFGE patterns of NTS causing bacteraemia and gastroenteritis did not differ significantly. The high prevalence of NTS strains resistant to most of the commonly used antimicrobials is of major public health concern.
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Swedish Inst Infect Dis Control, Dept Bacteriol, S-17182 Stockholm, SwedenSwedish Inst Infect Dis Control, Dept Bacteriol, S-17182 Stockholm, Sweden
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St Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, EnglandSt Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, England
Chiew, YF
Yeo, SF
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St Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, EnglandSt Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, England
Yeo, SF
Hall, LMC
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St Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, EnglandSt Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, England
Hall, LMC
Livermore, DM
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St Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, EnglandSt Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, England
机构:
Swedish Inst Infect Dis Control, Dept Bacteriol, S-17182 Stockholm, SwedenSwedish Inst Infect Dis Control, Dept Bacteriol, S-17182 Stockholm, Sweden
机构:
St Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, EnglandSt Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, England
Chiew, YF
Yeo, SF
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St Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, EnglandSt Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, England
Yeo, SF
Hall, LMC
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St Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, EnglandSt Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, England
Hall, LMC
Livermore, DM
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St Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, EnglandSt Bartholomews & royal London Sch Med & Dent, Dept Med Microbiol, Antibiot Grp, London E1 2AD, England