Berezin E N, Carvalho E da S, Farhat C K, Mimica I M, Mimica L, Raphaelian T A
Fac. de Med., Santa Casa de São Paulo.
AMB Rev Assoc Med Bras. 1990 Apr-Jun;36(2):100-6.
Salmonella is an important etiological agent of hospital infection in children, reaching endemic levels in some Brazilian states during the seventies and the eighties. We have prospectively studied twenty five children between four and one hundred eighty days old acutely infected with salmonella non typhi to determine the duration of carrier status and its clinical repercussion. After the diagnosis, the children were submitted monthly to clinical examination, and cultures were collected from skin, oropharynx, urine, stools, genitals, nostrils and auditive conduct. During the follow-up, eighteen (72%) children still had positive culture at four weeks after the diagnosis, ten (40%) at sixteen weeks, four (16%) at twenty weeks, and one (4%) at twenty four weeks. In eleven children, we performed biotype and antibiotic susceptibility study of the bacteria recovered at the diagnosis and during the follow-up. In every child the biotype of the bacteria recovered at the diagnosis and during the follow-up was the same. These data indicate that there is a persistent excretion of salmonella that can last for 24 weeks. Such bacterial elimination may be a dissemination source either to hospital or to home contacts. The use of specific antibiotics was effective for the clinical improvement of the patients during the acute disease, but it didn't avoid the carrier state.
沙门氏菌是儿童医院感染的重要病原体，在七十年代和八十年代期间，在巴西的一些州达到了地方流行水平。我们前瞻性地研究了25名年龄在4至180天之间急性感染非伤寒沙门氏菌的儿童，以确定带菌状态的持续时间及其临床影响。诊断后，每月对这些儿童进行临床检查，并从皮肤、口咽、尿液、粪便、生殖器、鼻孔和听觉传导部位采集培养样本。在随访期间，18名（72%）儿童在诊断后四周培养结果仍为阳性，10名（40%）在16周时阳性，4名（16%）在20周时阳性，1名（4%）在24周时阳性。我们对11名儿童在诊断时及随访期间分离出的细菌进行了生物型和抗生素敏感性研究。在每个儿童中，诊断时及随访期间分离出的细菌生物型相同。这些数据表明，沙门氏菌会持续排泄长达24周。这种细菌的排出可能是医院或家庭接触者的传播源。在急性疾病期间，使用特定抗生素对患者的临床改善有效，但并不能避免带菌状态。
