Salmonellosis: an epidemiologic study.

BACKGROUND

Salmonella species commonly produce acute gastroenteritis. The clinical course may be affected by factors such as age, immunosuppression, and underlying disorders.

OBJECTIVES

To investigate clinical and laboratory differences in the infected population and the risk of complications according to the different age groups.

METHODS

The records of 295 patients with positive cultures for Salmonella were divided into six age groups and reviewed retrospectively for the years 1994-1997. Demographic, clinical and laboratory data, extraintestinal manifestations, underlying disorders, organism source, and susceptibilty to antibiotics were analyzed.

RESULTS

We found that 88.5% were only stool positive, 9.2% had positive blood cultures, and 2.4% were positive in both blood and stool; 3.6% were found to have underlying disorders. Anemia, disturbed liver function tests and hypoalbuminemia were the most common pathologic laboratory findings. Salmonella serogroups B and D were isolated most frequently. The rate of positive blood cultures increased significantly during the years, as did resistance to ampicillin and trimethoprimsulfamethoxazole. Salmonella infection has two peaks of incidence: at ages 1-5 and 15-65 years. Bacteremia was prominent in the extreme ages.

CONCLUSIONS

Salmonella infection has a different clinical presentation in different age groups. The significant increase in the rate of bacteremia in the extreme age groups necessitates a different attitude and management for these heterogeneous patient populations.