Salmonelloses non typhoidiques en milieu pediatrique africain

A l'hopital pediatrique Albert Royer de Dakar; l'etude des salmonelles non typhoidiques de (1985-1989) a permis de colliger 35 dossiers. Elles representent 0;4 pour cent des hospitalisations et sont survenues essentiellement (83 pour cent) chez l'enfant age de moins de 3 ans; presentant surtout un terrain pathologique sous-jacent. Les principales formes cliniques ont ete septicemiques (46 pour cent) et digestives (31 pour cent). Parmi les formes localisees (23 pour cent) ; les meningites purulentes ont represente 45 pour cent. Un seul portage asymptomatique a ete decele. Les 17 serotypes de Salmonella isoles appartiennent a 8 serogroupes. S. enteridis et S. typhimurium ont constitue 51 pour cent des isolats. La sensibilite aux antibiotiques des differents serotypes a ete variable; les cephalosporines de troisieme generation et la gentamycine ayant inhibe plus de 80 pour cent des souches. La duree moyenne de l'antibiotherapie a ete de 21 jours avec une mortalite s'elevant a 17 pour cent. L'association ampicilline-gentamycine; bien que critiquable; garde son indication en traitement de 1ere intention a cause des disponibilites en produits

[Non typhoidic salmonellosis in the African pediatric population]. / Salmonelles non typhoïdiques en milieu pédidatrique africain.

The study of non-typhoidic salmonellosis in A. royer pediatric Hospital (Dakar) during a five year term (1985-1989) was realised on thirty five medical records. This pathology accounts for 0.4% of admissions and occurs mainly on children under 3 years old (83%) essentially with a pathologic background. The main clinical forms were septicemia (46%) and gastro-enteritis (31%). Purulent meningitidis represented 45% of all the localized forms. Only one case of asymptomatic carriage has been identified. The seventeen serotypes of Salmonella identified belong to eight serogroups. S. enteritidis and S. typhimurium represented 51% of the isolates. Susceptibility to antibiotics of these different serotypes were variable, the third generation cephalosporins and gentamycin having inhibited more than 80% of the strains. The mean duration of antibiotherapy was 21 days with a mortality rising to 17%. The association ampicilline-gentamycin although criticable, remains indication as first treatment because of the availability of these drugs.