[Non-typhi Salmonella bacteremia in children: an 11-year review].

OBJECTIVES: To review the clinical and bacteriological features of pediatric patients with non-typhi Salmonella (NTS) bacteremia.

METHODS: We reviewed the medical records of children aged less than 14 years with culture-proven NTS bacteremia in the previous 11 years in a referral hospital in Madrid, Spain.

RESULTS: A total of 29 cases of NTS bacteremia were diagnosed. Of these, 27 were used for study purposes. The mean age was 11.1 months (range: 3 days to 11 years); 48% were infants aged < 1 year. Eleven children (41%) had an underlying disease. These included immunodeficiency in seven (malignant disease in three, IgA-IgG2 deficit in one, chronic granulomatous disease in one, HIV infection in one, and systemic lupus erythematosus in one patient on steroid treatment), liver disease in three, and hypoxic-ischemic encephalopathy in one. Clinical manifestations at the initial visit included: fever > 39 C (85%), diarrhea (67%), and vomiting (37%). Seven patients had occult bacteremia. Three children (11 %) required intensive care management for severe sepsis. Five patients presented extraintestinal focal infections: arthritis in two, osteomyelitis in one, urinary tract infection in one, and pneumonia in one. None of the children had meningitis or died as a result of NTS infection. The most common serogroups isolated were Salmonella D9, and B4-5 (38% each). Eleven strains (38%) were resistant to amoxicillin and five (17%) were resistant to cotrimoxazole. Only one patient developed persistent bacteremia. All the children made a complete recovery without further complications.

CONCLUSIONS: NTS bacteremia is an uncommon entity but it should be considered in infants and immunocompromised children. Although focal complications may occur, the usual outcome with appropriate antimicrobial treatment is a full recovery.