Non-typhoidal Salmonella bacteremia in adults
Yung-Feng Yen, Yi-Chun Lin, Te-Li Chen, Yin-Yin Chen, Mei-Lin Lin, Fu-Der Wang, Chen-Yi Liu
Section of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming University, Taipei; Department of Medicine, Taichung Hospital, Department of Health, The Executive Yuan, Taipei; and The Committee of Nosocomial Infection Control, Taipei Veterans General Hospital, and Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
Received: March 20, 2006 Revised: May 22, 2006 Accepted: July 14, 2006
Background and purpose:
Very few studies have examined prognostic factors in adult patients with non-typhoidal Salmonella (NTS) bacteremia. The purpose of this study was to identify the prognostic factors of these patients.
A total of 79 episodes of NTS bacteremia were identified in 73 patients between January 2001 and December 2003. Susceptibilities to various antimicrobials were determined using disk-diffusion tests and National Committee for Clinical Laboratory Standards criteria. Multiple logistic regression was used to evaluate the relationship between patients’ characteristics and covariates of mortality.
There were only 5 episodes (6%) of gastroenteritis, two of which were due to Salmonella septicemia contracted abroad. Potentially predisposing factors were identifiable in 51 episodes (65%). Infections in 24 patients (30%) were due to serogroup B Salmonella and in 22 patients (28%), to serogroup C Salmonella. A logistic regression analysis selected two variables as independently influencing prognosis: coma (p=0.006) and septic shock (p=0.002).
Thus, most adult patients with NTS bacteremia do not develop gastroenteritis. Patients in shock or coma have poor prognosis, and susceptibility to third-generation cephalosporins, cefepime, and carbapenem is high.
Bacteremia; Risk factors; Salmonella infections; Serotyping
J Microbiol Immunol Infect. 2007;40:227-233.