P20 A case of MDR <i>Salmonella</i> Stanleyville bacteraemia in an infant following travel to Nigeria

Abstract Background and Objectives Salmonella is a leading cause of bacterial foodborne gastrointestinal illness worldwide. Growing antimicrobial resistance (AMR) among travel associated gastroenteritis is a global concern. Sporadic cases of Salmonella Stanleyville had been reported earlier in the UK. However, to our knowledge, this is the first report of Salmonella Stanleyville bacteraemia in the UK. Case summary We describe a 12-month-old infant presenting with fever and lethargy along with 10 days of unresolving diarrhoea after returning from a family visit to Nigeria. She was started on initial supportive treatment and IV ceftriaxone as standard hospital antibiotic policy. However, she remained febrile with rising CRP following 48 h of treatment. Antibiotic was changed to meropenem following a growth of MDR Salmonella sp., later identified as Salmonella Stanleyville from the admission blood and stool cultures. The same organism was also isolated from a repeat blood culture after 48 h of admission confirming persistent bacteraemia. She recovered after 10 days of hospitalization with broad-spectrum antibiotic treatment. Conclusions Clinicians should be vigilant about the choice of antibiotic treatment for travel associated diarrhoea with prolonged fever from west and central African regions where resistance among food-borne pathogens is rapidly rising.