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Home > Vol 43, No 3 (2025) > Samphantharat

Non-Typhoidal Salmonella Gastroenteritis Outcomes in Immunocompetent Children

Suppasiri Samphantharat, Kamolwish Laoprasopwattana

Abstract

Objective: To compare the clinical outcomes in children older than 3 months with non-typhoidal Salmonella (NTS) gastroenteritis treated with or without empirical antibiotics.
Material and Methods: Medical records of all patients aged 3 months to 15 years having experienced their first episode of NTS and treated at Songklanagarind Hospital from January 2007 until December 2021 were reviewed.
Results: NTS infections occurred in 18 (8.0%) of 224 patients, with NTS gastroenteritis. Antibiotics were empirically prescribed to 159 (70.9%) patients. The antibiotics group included a significantly higher proportion of patients with a general sick appearance (20.1% vs. 6.3%), bloody diarrhea (56.6% vs. 33.3%), and abdominal pain (12.9% vs. 1.9%) than that in the no-antibiotics group. The antibiotics group seemed to have a shorter median (interquartile range [IQR]) duration of bloody diarrhea (3.0 [1.3–4.8] vs. 4.5 (3.0–6.5) days, p-value=0.051), but similar duration for fever (3.0 [1.0–4.0] vs. 3.0 [1.3–5.0] days, p-value=0.566) compared to that for the no-antibiotics group. In multivariate analysis, children with underlying diseases (extravascular hemolytic anemia and/or abnormal kidney and urinary bladder system), fever duration >5 days by the first visit, and white blood cell (WBC) count >15,000 cells/mm3 were at risk of iNTS infections, with an odds ratios (95% confidence intervals) of 7.96 (1.70, 37.30), 7.75 (1.74, 34.46), and 8.69 (2.39, 31.55), respectively.
Conclusion: Patients aged 3-36 months with NTS gastroenteritis having an underlying disease, fever duration >5 days, and/or WBC count >15,000 cells/mm3 should be treated with empirical antibiotics while waiting for hemoculture.

 Keywords

antibiotics; invasive NTS; non-typhoidal Salmonella infection; NTS; Immunocompetent children; risk factor

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References

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DOI: http://dx.doi.org/10.31584/jhsmr.20241135

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About The Authors

Suppasiri Samphantharat
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110,
Thailand

Kamolwish Laoprasopwattana
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110,
Thailand

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