Salmonella typhimurium outbreak in a neonatal unit in Turkey

To analyze an outbreak caused by a multipl resistant strain of S. typhimurium in a newborn unit in Turkey. The outbreak occured 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. Of 22 infants who were affected two died. Cases developed diarrhea (n=20), septicemia (n=5) and meningtis (n=1). The strain was resistant to ampicillin, ceftriaxone, ceftazidime, amikacin, trimethoprim-sulfamethoxasole and chloromphenicol, susceptible to meropenem. All of the infected neonates were treated with meropenem. The surveillance cultures were negative. The outbreak was controlled by approprite 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. 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.