Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Mar 7;68(Suppl 2):S177-S182.
doi: 10.1093/cid/ciy1126.

Epidemiology and Antimicrobial Susceptibility of Salmonella enterica Bloodstream Isolates Among Febrile Children in a Rural District in Northeastern Tanzania: A Cross-sectional Study

Omari A Msemo  1 , Joyce Mbwana  1 , Coline Mahende  1 , Anangisye Malabeja  1 , Samwel Gesase  1 , John A Crump  2 , Denise Dekker  3 , John P A Lusingu  1
Affiliations

Epidemiology and Antimicrobial Susceptibility of Salmonella enterica Bloodstream Isolates Among Febrile Children in a Rural District in Northeastern Tanzania: A Cross-sectional Study

Omari A Msemo et al. Clin Infect Dis. .

Abstract

Background: Salmonella enterica including Salmonella Typhi and nontyphoidal Salmonella (NTS) are the predominant cause of community-acquired bloodstream infections in sub-Saharan Africa (sSA). Multiple-drug resistance and emerging fluoroquinolone resistance are of concern. Data on the age distribution of typhoid fever in sSA are scarce but essential for typhoid conjugate vaccine policy. We sought to describe Salmonella bloodstream infections, antimicrobial resistance, and age distribution at a rural district hospital in northeastern Tanzania.

Methods: From 2008 to 2016, febrile children or children with a history of fever aged 1 month to 5 years admitted to Korogwe District Hospital were enrolled. Demographic, clinical data and blood cultures were collected. Organisms were identified by conventional microbiological methods, and antimicrobial susceptibility test was done by disc diffusion.

Results: Of 4176 participants receiving blood cultures, 383 (9.2 %) yielded pathogens. Of pathogens, 171 (44.6%) were Salmonella enterica of which 129 (75.4%) were Salmonella Typhi, and 42 (24.6%) were NTS. The median (interquartile range age of participants was 13.1 (6.3-28.0) months for those with Salmonella Typhi and 11.5 (8.5-23.4) months for NTS. Of 129 Salmonella Typhi, 89 (89.9%) were resistant to amoxicillin, 85 (81.0%) to chloramphenicol, and 93 (92.1%) to trimethoprim-sulfamethoxazole compared with 22 (62.9%), 15 (39.4%), and 27 (79.4%), respectively, for NTS. Multidrug resistance was present in 68 (81.0%) of Salmonella Typhi and 12 (41.4%) of NTS.

Conclusion: Salmonella Typhi was the leading cause of bloodstream infection among infants and young children <2 years of age admitted to Korogwe District Hospital. Multidrug resistance was common, highlighting a role for typhoid conjugate vaccine into routine infant vaccine schedules.

Keywords: Salmonella Typhi; Epidemiology; antimicrobial resistance; non-typhoidal Salmonella.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Map of Korogwe showing residential addresses of Salmonella enterica patients.
Figure 2.
Figure 2.
Flow diagram of febrile children with blood stream infections in Korogwe Tanzania, 2008–2016.
Figure 3.
Figure 3.
Age distribution of children with Salmonella enterica blood stream infections in Korogwe, Tanzania, 2008–2016.
See this image and copyright information in PMC

References

    1. Jeon HJ, Pak GD, Im J, et al. . Determining the best immunization strategy for protecting African children against invasive Salmonella disease. Clin Infect Dis 2018; 67:1824–30. - PMC - PubMed
    1. Reddy EA, Shaw AV, Crump JA. Community-acquired bloodstream infections in Africa: a systematic review and meta-analysis. Lancet Infect Dis 2010; 10:417–32. - PMC - PubMed
    1. Rahman MA, Lorkowski S; Disease and Injury Incidence and Prevalence Collaborators G. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet; 2018; 392:1789–858. - PMC - PubMed
    1. Roth GA, Abate D, Abate KH, et al. . Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1736–88. - PMC - PubMed
    1. World Health Organization & UNICEF. Progress on sanitation and drinking water – 2015 update and MDG assessment. World Health Organization 2015.

Publication types

MeSH terms

Substances