Non - Typhoid Salmonella (NTS)
Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A02.9 DESCRIPTION Present as: gastroenteritis, or extra-intestinal (invasive) disease. DIAGNOSTIC CRITERIA Clinical Self-limiting mucosal intestinal disease presenting with diarrhoea and vomiting in immunocompetent patients. Young infants (< 3 months) and immunodeficient children (esp
Description
Diagnostic criteria
General and supportive measures
Medicine treatment
Referral
ICD-10 code: A02.9
DESCRIPTION
Present as:
- gastroenteritis, or
- extra-intestinal (invasive) disease.
DIAGNOSTIC CRITERIA
Clinical
- Self-limiting mucosal intestinal disease presenting with diarrhoea and vomiting in immunocompetent patients.
- Young infants (< 3 months) and immunodeficient children (especially HIV-infected children) are prone to invasive, often recurrent disease.
- Invasive disease includes bacteraemia (fever), osteomyelitis and meningitis.
- There is also an association of invasive NTS with malaria and severe anaemia.
Investigations
- Positive blood cultures, less commonly, stool, urine and bone biopsy.
GENERAL AND SUPPORTIVE MEASURES
- Correct and maintain fluid and electrolyte status.
MEDICINE TREATMENT
Note:
Relapse may occur despite adequate therapy. Antibiotic therapy in NTS gastroenteritis may prolong excretion of Salmonella.
Antibiotic therapy is not generally recommended for non-invasive disease. However, in infants < 3 months of age and severely immunocompromised children at high risk of developing invasive disease, treat as for invasive disease.
Invasive disease
If < 1 month of age:
- Cefotaxime, IV/IM.
| Gestational age | Postnatal age | Dose |
| < 32 weeks | < 14 days | 50 mg/kg/dose every 12 hours |
| 14–28 days | 50 mg/kg/dose every 8 hours | |
| ≥ 32 weeks | ≤ 7 days | 50 mg/kg/dose every 12 hours |
| 8–28 days | 50 mg/kg/dose every 8 hours |
OR
If > 1 month of age:
- Ceftriaxone, IV, 100 mg/kg once daily, (maximum 4 g/day).
Duration:- Bacteraemia: 10–14 days.
- Acute osteomyelitis: 4–6 weeks.
- Meningitis: 4 weeks.
If cephalosporin resistance reported, treat according to sensitivity.
REFERRAL
- Inadequate response to treatment.
- Patients with complications.
Standard Treatment Guidelines and Essential Medicines List for South Africa Paediatric Hospital _2023, 5th edition_Updated July 2024
Chapter 8: Infective/Infectious Diseases, 8.24 Non-typhoid Salmonella (NTS)