INCREASE IN ANTIMICROBIAL-RESISTANT SALMONELLA INFECTIONS IN THE UNITED-STATES, 1989-1990

To assess factors associated with antimicrobial-resistant Salmonella i nfections and trends in resistance, a prospective study of patients wi th culture-confirmed salmonellosis was done in 1989-1990. Patients wit h resistant infections were more likely than those with susceptible in fections to be hospitalized (P = .006), to be <1 year old (P = .003), to be black (P = .013), and to have recently been treated with an anti microbial agent (P = .085). Compared with data from a similar study in 1979-1980, increases were seen in the percentage of patients with res istant infections (from 17% to 31%), in the resistance to ampicillin ( 10% to 14%), and in the frequency of isolates found in blood (1% to 11 %). These data show that treatment of Salmonella infections may be com plicated by growing resistance to clinically important antimicrobial a gents and by an increasing frequency of extraintestinal complications. Antimicrobial agents with little demonstrated resistance should be co nsidered for patients with complicated illnesses and at high risk of h aving a resistant infection.