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The records of children with Salmonella gastroenteritis only (n = 97), and those with associated bacteraemia (n = 64), seen in one medical centre during a 12-year period, were analysed retrospectively. Mean patient age was 2.24 +/- 2.8 years (range, 0.05-16 years), and 49% were male. Children with bacteraemia presented after a longer duration of symptoms (7.0 +/- 6.9 vs. 3.9 +/- 4.6 days, p 0.0002), and had higher erythrocyte sedimentation rates (45 +/- 22 vs. 33 +/- 22 mm/h, p0.02) and lactate dehydrogenase values (924 +/- 113 vs. 685 +/- 165 IU/L, p 0.001). There was a trend in bacteraemic children towards immunosuppression (6.3% vs. 1.0%, p 0.08) and a lower number of siblings (2.9 +/- 1.9 vs. 3.8 +/- 2.7, p 0.063). Non-bacteraemic children had a more severe clinical appearance, and a higher percentage had a moderate to bad general appearance (51.5 vs. 29.7%, p0.01), with dehydration (37.1 vs. 18.8%, p 0.02) and vomiting (58.8 vs. 39.0%, p 0.02). Laboratory dehydration indicators were also markedly worse in non-bacteraemic children, with urine specific gravity of 1020 +/- 9.4 vs. 1013 +/- 9.0 (p 0.0002), base excess of - 4.2 +/- 3.0 vs. - 2.5 +/- 3.4 mEq/L (p 0.01), and blood urea nitrogen of 10.1 +/- 7.0 vs. 7.4 +/- 4.5 mg% (p 0.002). Thus, the clinical presentation of bacteraemic children was more gradual, and associated gastroenteritis and dehydration was less pronounced. These findings may contribute in part to the inadvertent discharge of bacteraemic children from the emergency department.

A case of non-typhi Salmonella empyema is reported. A review of the literature over the past century found only 13 other empyemas due to Salmonella typhimurium and 25 cases of other non-typhi Salmonella. A review of pleuropulmonary disease due to non-typhi Salmonella is provided along with management recommendations.

CTX-M-type beta-lactamases are increasing among US Enterobacteriaceae isolates. Of 2,165 non-Typhi Salmonella isolates submitted in 2007 to the National Antimicrobial Resistance Monitoring System, 100 (4.6%) displayed elevated MICs (≥2 mg/L) of ceftriaxone or ceftiofur. Three isolates (serotypes Typhimurium, Concord, and I 4,5,12:i:-) contained bla(CTX-M-5), bla(CTX-M-15), and bla(CTX-M-55/57), respectively.

Non-Typhi Salmonella cause over 1.7 million cases of gastroenteritis in North America each year, and food-animal products are commonly implicated in human infections. For invasive infections, antimicrobial therapy is indicated. In North America, the antimicrobial susceptibility of Salmonella is monitored by the U.S. National Antimicrobial Resistance Monitoring System (NARMS) and The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). In this study, we determined the susceptibility to cephalosporins by broth microdilution among 5,041 non-Typhi Salmonella enterica isolated from food animals, retail meats, and humans. In the United States, 109 (4.6%) of isolates collected from humans, 77 (15.7%) from retail meat, and 140 (10.6%) from food animals displayed decreased susceptibility to cephalosporins (DSC). Among the Canadian retail meat and food animal isolates, 52 (13.0%) and 42 (9.4%) displayed DSC. All isolates displaying DSC were screened for β-lactamase genes (bla(TEM), bla(SHV), bla(CMY), bla(CTX-M), and bla(OXA-1)) by polymerase chain reaction. At least one β-lactamase gene was detected in 74/109 (67.9%) isolates collected from humans, and the bla(CMY) genes were most prevalent (69/109; 63.3%). Similarly, the bla(CMY) genes predominated among the β-lactamase-producing isolates collected from retail meats and food animals. Three isolates from humans harbored a bla(CTX-M-15) gene. No animal or retail meat isolates harbored a bla(CTX-M) or bla(OXA-1) gene. A bla(TEM) gene was found in 5 human, 9 retail meat, and 17 animal isolates. Although serotype distributions varied among human, retail meat, and animal sources, overlap in bla(CMY)-positive serotypes across sample sources supports meat and food-animal sources as reservoirs for human infection.

Within a 5-year period, 64 patients were hospitalized at the Chang Gung Memorial Hospital of Keelung (Taiwan) with bacteremia due to non-typhi Salmonella. Fifteen were24 weeks of age, 17 were between 6 months and 5 years of age, and 32 were18 years of age. An analysis of these patients revealed several significant differences between pediatric and adult patients. For instance, 87.5% of the adults but none of the children were debilitated because of severe underlying disease. Mortality was high (40.6%) among adults, but no deaths were observed among the children. Diarrhea occurred significantly more frequently among children (68.7%) than among adults (15.6%), while the contrary was observed in regard to chills, which occurred in 31% of adults and none of the children. It is concluded that bacteremia due to non-typhi Salmonella presents with different clinical features in adults than it does in children; furthermore, in adults the disease can be considered life-threatening, but in children it is associated with a favorable prognosis.

The aim of the present study was to determine the bacteriological prevalence of subclinical non-typhi Salmonella infections in zoo animals and to determine the most frequently isolated serovars of the bacteria. A total of 267 samples were analyzed, including fecal samples from zoo animals and rodents, insects (Musca domestica and Periplaneta americana) and samples of the zoo animal's food. Salmonella was detected in 11.6% of the samples analyzed. Characterization of the isolates was performed with serotyping and pulsed-field gel electrophoresis. The following serovars were isolated: S. San Diego, S. Oranienburg, S. Weltevreden, S. Braenderup, S. Derby, S. 6,7, H:en x:- and S. 3,10, H:r:-. The isolates showed seven pulsed-field gel electrophoresis patterns with a Jaccard coefficient≥0.75 indicating a possible common origin. The prevalence of asymptomatic infections caused by Salmonella spp. in zoo animals was high. These findings demonstrate the diversity of Salmonella serovars in several captive wild animal species.

Centre Universitaire Eltarf, Eltarf, Algerie; Universite Paris-Est, Ecole Nationale Veterinaire d’Alfort, Unite Microbiologie Alimentaire, Securite et Qualite des Aliments (MASQ), 94704 Maisons-Alfort Cedex, France; Service de Microbiologie, Centre Hospitalier Universitaire Dorban, Annaba, Algerie; Unite Caracterisation et Epidemiologie Bacterienne (CEB), Laboratoire de Securite des Aliments de Maisons-Alfort, ANSES, 94706 MaisonsAlfort Cedex, France; INSERM U914 ‘Emerging Resistance to Antibiotics’, Service de Bacteriologie-Virologie, Hopital de Bicetre, Faculte de Medecine Paris-Sud, 94275 Le Kremlin-Bicetre, Paris, France

Osteoarticular infections caused by Non-typhi Salmonella are exceptionally encountered. We report a case of a bacteriologically documented hip infection associated with a psoas abscess due to Non-typhi Salmonella. A 64-year-old immunocompetent male was admitted in our department for pain and motion range limitation in the right hip with fever. Non-typhi Salmonella was recovered in joint fluid obtained by needle aspiration. Antimicrobial chemotherapy combined with surgical intervention was necessary for eradication of the infection. Physicians should be aware of this rare manifestation of Non-typhi Salmonella infections in non-debilitated patients.

Fluoroquinolones commonly are used to treat adult Salmonella infections. Fluoroquinolone treatment has failed for persons infected with nalidixic acid-resistant Salmonella . From 1996 to 2003, state public health laboratories forwarded 12,252 non-Typhi Salmonella enterica isolates to the Centers for Disease Control and Prevention for antimicrobial susceptibility testing; 203 (1.6%) of the isolates were nalidixic acid resistant, and 14 (7%) of those were ciprofloxacin resistant. Resistance to nalidixic acid significantly increased from 0.4% in 1996 to 2.3% in 2003. All ciprofloxacin-resistant isolates had at least one point mutation in the quinolone resistance determining region (QRDR) of gyrA and did not harbor qnr or have point mutations in the QRDR of gyrB , parC , or parE . Continued surveillance of antimicrobial resistance among non-Typhi S. enterica isolates is needed to mitigate the increasing prevalence of nalidixic acid resistance.

Gastroenteritis, caused by Salmonella spp. is usually a self-limiting infection and does not require treatment. However, in some immunosuppressed patients (such as the newborn, the elderly, those with AIDS or neoplasms), there is a greater risk of developing a severe systemic infection, and in these cases, antibiotic treatment is recommended. Third-generation cephalosporins and fluoroquinolones are the most useful antibiotics in the treatment of these infections, although resistant strains are sometimes isolated. Therapeutic failures have been reported with fluoroquinolones in extra-intestinal infections caused by nalidixic acid resistant strains.

Objectives: To determine if the epidemiology of Salmonella gastroenteritis and childhood bacteremia among the two ethnic populations (Jews and Bedouins) living in southern Israel has changed in recent years.Methods: Retrospective review of laboratory records and medical charts of patients from whom non-typhi salmonellae were isolated from stool and blood cultures in the 1990–1995 period.Results: The overall incidence of enteric Salmonella infections was 123.5 per 100 000 inhabitants and remained stable during the study period. The incidence of bacteremia among children younger than 4 years increased from 9.3 per 100 000 in the 1990–1992 period to 26.8 per 100 000 in the 1993–1995 period (P