Salmonella Infections in Asir Region, Southern Saudi Arabia: Expatriate Implications

One hundred forty-two cases of salmonella infection seen in Asir region, Southern Saudi Arabia, during the period of 1989-1991 inclusive, were analyzed. Ninety-four cases were found to have enteric fever and 48 cases were found to have, Salmonella enteritidis gastroenteritis. Enteric fever is more common in non-Saudis (64%) than in the indigenous Saudi population (34%). Salmonella enteriditis gastroenteritis is more common among the Saudi population (75%) than non-Saudis (25%). The clinical presentation of both types of salmonella infection is outlined. Enteric fever is more common among expatriates who recently came from India (40.5%), Egypt (10.6%), Pakistan (6.4%), and Syria (4.3%). Salmonella typhi resistant to tetracycline, ampicillin, and chloramphenicol are more common among Indian patients (75% of resistant cases) and Syrian patients (12.5-28% of resistant cases). Resistance to cotrimoxazole is commonly encountered in Indians (50% of resistant cases) and Egyptians (33.3%). Salmonella enteriditis resistant to tetracycline, ampicillin, and chloramphenicol is more common among Saudis (66.7% of resistant cases) and Filipinos (16.7-33.3% of resistant cases). Recommendations regarding screening of expatriates for enteric fever and proper drug therapy of possible resistant cases are outlined.