Salmonella enterica serovars Panama and Arechavaleta: Risk Factors for Invasive Non-Typhoidal Salmonella Disease in Guadeloupe, French West Indies

Stephanie Guyomard-Rabenirina Unité Environnement et Santé, Institut Pasteur de Guadeloupe, Pointe-à-Pitre, France;

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Blandine Muanza Service de Pédiatrie, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France;

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Sylvaine Bastian Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France;

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Edith Malpote Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France;

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Pauline Jestin Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France;

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Meggie Guerin Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France;

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Antoine Talarmin Unité Environnement et Santé, Institut Pasteur de Guadeloupe, Pointe-à-Pitre, France;

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François-Xavier Weill Unité des Bactéries Pathogènes Entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Institut Pasteur, Paris, France;

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Arnaud Legrand Direction de la Recherche Clinique et de L’innovation, Centre Hospitalier Universitaire de Nantes, Nantes, France;

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Sebastien Breurec Unité Environnement et Santé, Institut Pasteur de Guadeloupe, Pointe-à-Pitre, France;
Unité des Bactéries Pathogènes Entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Institut Pasteur, Paris, France;
Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles, Pointe-à-Pitre, France

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A retrospective study was conducted to identify the risk factors associated with Salmonella enterica bacteremia in infants and children in Guadeloupe, French West Indies. The 171 patients with S. enterica infection seen between 2010 and 2014 included 155 (90.6%) with acute gastroenteritis, of whom 42 (27.1%) had concomitant bacteremia, and 16 (9.4%) with primary bacteremia. Most cases (97.7%) were in infants and children with no underlying health condition. Two subspecies were recovered: enterica (N = 161, 94.2%) and houtenae (N = 10, 5.8%). All but one (serovar Typhi) were non-typhoidal Salmonella. The most common serovars were Panama (N = 57, 33.3% of isolates) and Arechavaleta (N = 28, 16.4%). Univariate analysis showed a strong association only between age > 6 months and infection with the Panama or Arechavaleta serovar (P = 0.002). The rate of resistance to all classes of antibiotics during the study period was low (< 15%); however, the detection of one extended-spectrum beta-lactamase–producing S. enterica strain highlights the need for continued monitoring of antimicrobial drug susceptibility. Infection with Panama (P < 0.001) or Arechavaleta (P < 0.001) serovar was significantly associated with bacteremia in a multivariate analysis. These serovars are probably poorly adapted to humans or are more virulent. A delay between onset of symptoms and hospital admission > 5 days (P = 0.01), vomiting (P = 0.001), and increased respiratory rate (P = 0.001) contributed independently to bacteremia in the multivariate analysis. Thus, if non-typhoidal infection is suspected, blood should be cultured and antibiotic treatment initiated in all patients who meet these criteria.

Author Notes

Address correspondence to Sebastien Breurec, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Laboratoire de Microbiologie Clinique et Environnementale, Route de Chauvel, Pointe-à-Pitre 97157, France. E-mail: sebastien.breurec@chu-guadeloupe.fr

Financial support: The French National Reference Centre for Escherichia coli, Shigella and Salmonella is funded by the Institut Pasteur and Santé Publique France. The Unité des Bactéries Pathogènes Entériques is part of the Integrative Biology of Emerging Infectious Diseases Laboratory of Excellence funded by the French Government as part of the Investissement d'Avenir programme (grant no. ANR-10-LABX-62-IBEID).

Authors’ addresses: Stephanie Guyomard-Rabenirina and Antoine Talarmin, Unité Environnement et Santé, Institut Pasteur de Guadeloupe, Pointe-à-Pitre, France, E-mails: sguyomard@pasteur-guadeloupe.fr and atalarmin@pasteur-guadeloupe.fr. Blandine Muanza, Service de Pédiatrie, Centre Hospitalier Universitaire de Pointe-à-Pitre/Les Abymes, Pointe-à-Pitre, France, E-mail: blandine.muanza@chu-guadeloupe.fr. Sylvaine Bastian and Edith Malpote, Centre Hospitalier Universitaire de Pointe-à-Pitre/Les Abymes, Laboratoire de Microbiologie Clinique et Environnementale, Pointe-à-Pitre, France, E-mails: sylvaine.bastian@chu-guadeloupe.fr and edith.malpote@chu-guadeloupe.fr. Pauline Jestin, Laboratoire de Biologie Médicale, GH de La Rochelle-Ré-Aunis, Rue du Docteur Schweitzer, La Rochelle, France, E-mail: pauline.jestin@ch-larochelle.fr. Meggie Guerin, Centre Hospitalier Andrée Rosemon, Laboratoire Hospitalier et Universitaire de Parasitologie-Mycologie, Cayenne, France, E-mail: meggie.guerin@gmail.com. François-Xavier Weill, Unité des Bactéries Pathogènes Entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Institut Pasteur, Paris, France, E-mail: fxweill@pasteur.fr. Arnaud Legrand, Direction de la Recherche Clinique et de L’innovation, Centre Hospitalier Universitaire de Nantes, Nantes, France, E-mail: arnaud.legrand@chu-nantes.fr. Sebastien Breurec, Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France, E-mail: sebastien.breurec@chu-guadeloupe.fr.

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