Hot Topics in Infection and Immunity in Children IX
Hot Topics in Infection and Immunity IX
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Non-typhoidal Salmonella in Children: Microbiology, Epidemiology and Treatment Gabrielle M. Haeusler and Nigel Curtis
Abstract
Non-typhoidal Salmonellae (NTS) are an important cause of infectious diarrhoea world-wide. In the absence of immune deficiency, gastroenteritis caused by NTS is usually mild, self limiting and rarely requires intervention. NTS are also an important cause of invasive disease, particularly in developing countries, likely secondary to the high prevalence of coexisting malnutrition, malaria and HIV infection. This review provides an overview of the microbiology, epidemiology and pathogenesis of NTS, and compares recommendations for the treatment of NTS gastroenteritis in children.
2.1 Introduction Non-typhoidal Salmonellae (NTS) are an important cause of infectious diarrhoea world-wide. In the absence of immune deficiency, gastroenteritis caused by NTS is usually mild, self limiting and rarely requires intervention. NTS are also an important cause of invasive disease, particularly in developing countries, likely secondary to N. Curtis () Department of Paediatrics, The University of Melbourne; Infectious Diseases Unit, The Royal Children’s Hospital Melbourne; Infectious Diseases & Microbiology Research Group, Murdoch Children’s Research Institute, Parkville, Australia e-mail: [email protected] G. M. Haeusler Infectious Diseases Unit, The Royal Children’s Hospital Melbourne, Parkville, Australia e-mail: [email protected]
the high prevalence of co-existing malnutrition, malaria and HIV infection. Antibiotic treatment of NTS gastroenteritis has been the subject of a meta-analysis, but questions regarding exactly which patients should be treated and the optimal regimen remain unanswered. This review provides an overview of the microbiology, epidemiology and pathogenesis of NTS, and compares recommendations for the treatment of NTS gastroenteritis in children.
2.2 Classification and Microbiology The genus Salmonella belongs to the family of Enterobacteraciae. Salmonella are separated into two species, Salmonella enterica and Salmonella bongori (previously classified as subsp. V.), with the former being further classified into six subspecies (I, S. enterica subsp. enterica; II,
N. Curtis et al. (eds.), Hot Topics in Infection and Immunity in Children IX, Advances in Experimental Medicine and Biology 764, DOI 10.1007/978-1-4614-4726-9_2, © Springer Science+Business Media New York 2013
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G. M. Haeusler and N. Curtis
Table 2.1 Number of serotypes in each subspecies. (Based on data from Grimont et al. [1]) Species
Subspecies
Number of serotypes
1,531 enterica (I) 505 salamae (II) 99 arizonae (IIIa) 336 diarizonae (IIIb) 73 houtenae (IV) 13 indica (VI) 22 Salmonella bongori (V) – Total 2,579
Table 2.2 Examples of clinically significant Salmonella serotypes and relevant clinical syndromes according to serogroup. (Based on data from Grimont et al. [1]) Serogroup
Salmonella enterica
S. enterica subsp. salamae; IIIa, S. enterica subsp. arizonae; IIIb, S. enterica s
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