[Persistence of colonization time in patients infected by Salmonella].

E N Berezin, E da S Carvalho, C K Farhat, I M Mimica, L Mimica, T A Raphaelian
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Abstract

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.

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[沙门氏菌感染患者定殖时间的持久性]。
沙门氏菌是儿童医院感染的重要病原体,在七、八十年代在巴西的一些州达到地方病水平。我们前瞻性地研究了25名年龄在4至180天的儿童急性感染非伤寒沙门氏菌,以确定携带者状态的持续时间及其临床反应。诊断后,每月对患儿进行临床检查,收集皮肤、口咽、尿液、粪便、生殖器、鼻孔和听觉行为培养物。在随访期间,18名(72%)儿童在诊断后4周仍有阳性培养,10名(40%)在16周,4名(16%)在20周,1名(4%)在24周。在11例患儿中,我们对诊断时和随访期间恢复的细菌进行了生物型和抗生素敏感性研究。在每个儿童中,诊断时和随访期间恢复的细菌的生物型是相同的。这些数据表明,沙门氏菌的持续排泄可以持续24周。这种细菌消除可能是医院或家庭接触者的传播源。急性期特异性抗生素的使用对患者的临床改善是有效的,但并不能避免患者进入携带者状态。
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