Portal de Periódicos da CAPES

Invasive Salmonella Infections Among Children From Rural Mozambique, 2001–2014

2015; Oxford University Press; Volume: 61; Issue: suppl 4 Linguagem: Inglês

10.1093/cid/civ712

1537-6591

Inácio Mandomando, Quique Bassat, Betuel Sigaúque, Sérgio Massora, Llorenç Quintó, Sozinho Acácio, Tacilta Nhampossa, Delfino Vubil, Marcelino Garrine, Eusébio Macete, Pedro Aíde, Charfudin Sacoor, Laura Herrera, Joaquı́m Ruiz, Sharon M. Tennant, Clara Menéndez, Pedro L. Alonso,

Antibiotic Resistance in Bacteria

Background. Invasive nontyphoidal Salmonella (iNTS) has emerged as a cause of bacteremia in African children and HIV-infected adults, which is associated with high mortality. Epidemiological data and burden of iNTS infections in resource-constrained settings are needed to better define preventive and curative strategies. Methods. Blood and, if appropriate, cerebrospinal fluid, were collected from children <15 years of age with fever or severe disease admitted to the Manhiça District Hospital and cultured for NTS; isolates were then characterized. Results. From January 2001 to December 2014, 41 668 of the 51 878 admitted children had a blood culture performed. Invasive NTS was isolated from 670 (1.6%) specimens collected from 41 668 patients; 69 (10.3% died). Salmonellaenterica subspecies enterica serovar Typhi or Salmonellaenterica subspecies enterica serovar Paratyphi A or C were only isolated in 14 (0.03%) patients. A total of 460 of 620 (74.2%) NTS isolates serotyped were Salmonellaenterica subspecies enterica serovar Typhimurium (45% [116/258] of which were multilocus sequence type 313). The incidence of iNTS was 61.8 (95% confidence interval, 55.4–68.9) cases per 100 000 child-years, being highest among infants (217.7 cases/100 000 child-years). The incidence of iNTS declined significantly (P < .0001) over time, but the case fatality ratio remained constant at approximately 10%. Antimicrobial resistance of iNTS against most available antimicrobials has steadily increased, with a predominance of multidrug-resistant strains. Conclusions. The decreasing but still high incidence of iNTS, its high associated case fatality ratio, and the common detection of multidrug-resistant strains call for a need to improve treatment and prevention strategies for iNTS.