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http://hdl.handle.net/1956/2267
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| Tittel: | Nosocomial outbreak of neonatal Salmonella enterica serotype Enteritidis meningitis in a rural hospital in northern Tanzania |
| Forfattere: | Vaagland, Hogne
Blomberg, Bjørn
Krüger, Carsten
Naman, Naftali
Jureen, Roland
Langeland, Nina |
| Dato: | 14-Sep-2007 |
| Forlag: | BioMed Central Ltd. |
| Serie/Rapport nr.: | BMC Infectious Diseases 4(35) |
| Sammendrag: | Background: Clinicians at Haydom Lutheran Hospital, a rural hospital in northern Tanzania noted
an unusually high case-fatality rate of pediatric meningitis and suspected an outbreak of an unknown
agent or an organism resistant to the empirical therapy.
Methods: We established a provisional microbiology laboratory to investigate the suspected
outbreak. Blood and spinal fluid specimens were taken from children below the age of seven years
with suspected meningitis. The blood and spinal fluid specimens were inoculated in commercial
blood culture bottles and locally prepared Thayer-Martin medium in slanted tubes, respectively.
The bacterial isolates were sent to Norway for further investigation, including susceptibility testing
and pulsed-field gel-electrophoresis (PFGE).
Results: Among 24 children with suspected meningitis and/or septicemia, five neonates had
meningitis caused by Salmonella enterica serotype Enteritidis, all of whom died. Two children had S.
Enteritidis septicemia without meningitis and both survived. Genotyping with PFGE suggested a
clonal outbreak. The salmonella strain was resistant to ampicillin and sensitive to gentamicin, the
two drugs commonly used to treat neonatal meningitis at the hospital.
Conclusion: The investigation reminds us that nontyphoidal salmonellae can cause meningitis
associated with very high case-fatality rates. Resistance to multiple antimicrobial agents increases
the risk of treatment failure and may have contributed to the fatal outcome in all of the five patients
with salmonella meningitis. The investigation indicated that the outbreak was nosocomial and the
outbreak subsided after hygienic measures were instituted. Establishing a provisional
microbiological laboratory is a valuable and affordable tool to investigate and control outbreaks
even in remote rural areas. |
| URI: | http://dx.doi.org/10.1186/1471-2334-4-35
http://hdl.handle.net/1956/2267 |
| Vises i samlingene: | Centre for International Health
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