RESUMO
A 4-year retrospective study was undertaken at the Kilifi District Hospital on the coast of Kenya to determine the antibiotic-susceptibility patterns and genotypes of non-typhi Salmonella (NTS) isolates from children. Overall, during the period 1994-97, positive cultures were obtained from 543 (14%) of 3885 blood samples, 364 (30%) of 1210 stool samples and 143 (11%) of 1283 cerebrospinal fluid (CSF) samples. NTS were isolated from 151 (27.8%), 72 (19.8%), and 11 (7.7%) of these positive cultures, respectively. The total 234 NTS isolates were serotyped: the most frequent were Salmonella enterica serotype Enteritidis (41%) and S. enterica serotype Typhimurium (38%). Antibiotic sensitivity testing was done using ampicillin (amp), chloramphenicol (chl), gentamicin (cn), co-trimoxazole (s-t), cefuroxime (cxm), ciprofloxacin (cip), cefotaxime (ctx), amoxicillin-clavulanic acid 20 micrograms-10 micrograms (amc), and tobramycin (tob). Of the 234 isolates, 43 were sensitive to all antibiotics tested and 133 were multiple drug resistant (MDR). The most common resistance type seen was amp, cn, cxm, s-t, ctx, amc, tob (36/234). Our results indicate a high proportion of MDR amongst the isolates from Kilifi. We conclude that 2 major serotypes of salmonella, i.e., S. enterica serotype Typhimurium and S. enterica serotype Enteritidis, of micro-epidemic nature that have been previously unrecognized in Kilifi are responsible for infection in Kilifi district on the coast of Kenya and that over half (56.8%) of total NTS isolates are MDR.
Assuntos
Infecções por Salmonella/tratamento farmacológico , Criança , Pré-Escolar , Resistência Microbiana a Medicamentos , Resistência a Múltiplos Medicamentos , Eletroforese em Gel de Campo Pulsado , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Quênia/epidemiologia , Masculino , Estudos Retrospectivos , Salmonella/genética , Salmonella/isolamento & purificação , Infecções por Salmonella/epidemiologia , Salmonella enterica/genética , Salmonella enterica/isolamento & purificação , Sorotipagem/métodosRESUMO
We present the clinical course of four children involved in an outbreak of intravenous cannulae associated nosocomial septicaemia due to multidrug-resistant Klebsiella pneumoniae. The patients involved, two of whom died became bacteraemic within a three week period, and evidence for an environmental source of the organism was obtained.
