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BIBTEX RIS

Clinical and Microbiological Features of Salmonella Meningitis in a South African Population, 2003–2013

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

10.1093/cid/civ685

ISSN

1537-6591

Autores

Karen H. Keddy, Arvinda Sooka, Alfred Musekiwa, Anthony M. Smith, Husna Ismail, Nomsa P. Tau, Penny Crowther-Gibson, Frederick J. Angulo, Keith P. Klugman,

Tópico(s)

Antibiotic Resistance in Bacteria

Resumo

Background. The clinical and microbiological characteristics of nontyphoidal Salmonella (NTS) meningitis in South Africa, where human immunodeficiency virus (HIV) prevalence is high (approximately 15% in persons ≥15 years of age), were reviewed. Methods. From 2003 through 2013, 278 cases were identified through national laboratory-based surveillance. Clinical information (age, sex, outcome, Glasgow Coma Scale [GCS], and HIV status) was ascertained at selected sites. Isolates were serotyped; susceptibility testing and multilocus sequence typing on Salmonella enterica serovar Typhimurium isolates was performed. Multivariable logistic regression was used to determine factors associated with mortality outcome, using Stata software, version 13. Results. Where age was ascertained, 139 of 256 (54.3%) patients were 15 years were HIV infected, compared with 24 of 46 (52.2%) patients aged <5 years. Neonates were less likely to be HIV infected than infants aged 2–12 months (OR, 4.8; 95% CI, 1.1–21.1; P = .039). Salmonella Typhimurium represented 106 of 238 (44.5%) serotyped isolates: 65 of 95 (68.4%) were ST313 vs ST19, respectively, and significantly associated with HIV-infected patients (P = .03) and multidrug resistance (OR, 6.6; 95% CI, 2.5–17.2; P < .001). Conclusions. NTS meningitis in South Africa is highly associated with HIV in adults, with neonates (irrespective of HIV status), and with Salmonella Typhimurium ST313. GCS is the best predictor of mortality: early diagnosis and treatment are critical. Focused prevention requires further studies to understand the sources and transmission routes.

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