Nontyphoid Salmonella Infection: Microbiology, Clinical Features, and Antimicrobial Therapy

Pediatrics and Neonatology

卷:54

Lin-Hui Su¹  Cheng-Hsun Chiu²  Hung-Ming Chen³  Yue Wang⁴ 

[1] Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan;

[2] Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan;

[3] Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University of Science and Technology, Chiayi, Taiwan;

[4] Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, PR China;

关键词: antimicrobial resistance;    antimicrobial therapy;    Salmonella infection;   

DOI  :  10.1016/j.pedneo.2013.01.010

来源: DOAJ

【 摘 要 】

Nontyphoid Salmonella is the most common bacterial pathogen causing gastrointestinal infection worldwide. Most nontyphoid Salmonella infection is limited to uncomplicated gastroenteritis that seldom requires antimicrobial treatment. Nevertheless, invasive infections, such as bacteremia, osteomyelitis, and meningitis, may occur and require antimicrobial therapy. Continuous genetic and genomic evolution in Salmonella leading to increased virulence and resistance to multiple drugs are of significant public health concern. Two major changes in the epidemiology of nontyphoid salmonellosis in Europe and in the USA occurred in the second half of the 20th century: the emergence of foodborne human infections caused by Salmonella enterica serotype Enteriditis and by multidrug-resistant strains of Salmonella enterica serotype Typhimurium. In the 21st century, a worsening situation is the increasing resistance to fluoroquinolones and third-generation cephalosporins in nontyphoid Salmonella. Clinical isolates showing carbapenem resistance also have been identified. Although antimicrobial therapy is usually not indicated for uncomplicated Salmonella gastroenteritis, recent studies indicated that a short-course ceftriaxone therapy (3–5 days) for patients with severe gastroenteritis would lead to a faster clinical recovery. Continuous surveillance of Salmonella in both humans and animals is mandatory. A better understanding of the mechanisms that lead to the emergence of antimicrobial resistance in Salmonella may help in the devising of better interventional strategies to reduce the spread of resistant Salmonella between humans and reservoirs along the food chain.

【 授权许可】

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