Increasing incidence of non-typhi Salmonella bacteremia among children living in southern Israel

Objectives: To determine if the epidemiology of Salmonella gastroenteritis and childhood bacteremia among the two ethnic populations (Jews and Bedouins) living in southern Israel has changed in recent years. Methods: Retrospective review of laboratory records and medical charts of patients from whom non-typhi salmonellae were isolated from stool and blood cultures in the 1990-1995 period. Results: The overall incidence of enteric Salmonella infections was 123.5 per 100 000 inhabitants and remained stable during the study period. The incidence of bacteremia among children younger than 4 years increased from 9.3 per 100 000 in the 1990-1992 period to 26.8 per 100 000 in the 1993-1995 period (P<0.01). This increment was especially caused by Salmonella virchow and S. enteritidis, which were also isolated with increasing frequency from stool cultures. The Bedouin population was underrepresented among stool isolates, whereas its representation among blood isolates closely resembled the fraction of this ethnic group in the overall population of the area. Conclusions: The incidence of enteric salmonellosis has remained stable at a high endemic level in recent years in southern Israel. The incidence of children's bacteremia has experienced a significant increase, associated with S. virchow and S. enteritidis. Differences in the utilization of medical services may explain differences in the epidemiology of Salmonella infections found in the two resident ethnic groups.