Analysis of clinical characteristics of invasive non-typhoidal Salmonella infections in children: a 5-year dual-center retrospective study
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Objective
To investigate the incidence, microbiological characteristics, clinical manifestations, and antibiotic resistance of invasive non-typhoidal Salmonella (iNTS) infections in children.
Methods
A retrospective study was conducted from January 2018 to December 2022 at two large teaching hospitals: Zhejiang University School of Medicine Children’s Hospital (ZCH) and Children’s Hospital of Soochow University (SCH). Medical records of culture-confirmed iNTS cases were reviewed, and a standardized case report form was used to collect demographic, clinical, and microbiological data.
Results
A total of 109 cases of iNTS infection were included, with 40 cases from SCH and 69 cases from ZCH. 71 cases (65.1%) were boys.. Infants under 1 year old accounted for 30.3% of the cases. Among the cases, 38 cases (34.9%) had underlying diseases, mainly tumors (55.3%,21/38). The most common sites of infection were the bloodstream (84.4%) and bones and joints (12.8%). The most common serogroups were B (36.8%), C (44.7%) and D (38.2%). The overall resistance rate of ampicillin was 53.6%, ceftriaxone resistance rate was 17.8%, and carbapenem resistance rate was 0%. Seasonal trends indicated higher incidence rates during the summer.
Conclusion
iNTS infections in children primarily affect the bloodstream and bones/joints, with a significant proportion of cases in those with underlying medical conditions. Ceftriaxone remains the first-line antibiotic, but increasing resistance highlights the need for vigilant antimicrobial stewardship. Carbapenems can be considered as second-line antibiotics in severe cases. Further studies are needed to understand the molecular characteristics and improve treatment strategies for iNTS infections in pediatric patients.
