Hospital Salmonella johannesburg infection and its possible role in the community spread of the infection in Hong Kong.

Salmonella johannesburg (1, 40: b: e, n, x), a previously rare salmonella serotype, has established itself rapidly as an important and highly prevalent cause of gastroenteritis among children. The clinical features of the infection are usually mild but chronic. It has been suggested that S. johannesburg was introduced into Hong Kong through imported foods but no common vehicle could be traced as the source of infection. A thorough investigation of one paediatric ward in a general hospital revealed that non-infected patients admitted to the ward usually acquired S. johannesburg infection within 3-7 days, with or without symptoms. Thus hospital cross-infection could be a significant factor in contributing to its rapid spread in the community. Furthermore, the rapidity with which S. johannesburg spread was facilitated by (a) its tendency to produce a chronic infection, (b) its multiple resistance to antibiotics, and (c) the higher infectivity of S. johannesburg over other salmonellas endemic in this locality. These factors combined with the overcrowded conditions in many of the hospitals in Hong Kong facilitated the occurrence of hospital infection, which in its turn contributed to the spread of the infection in the local community.