Abstract
Retrospectively reviewed charts of patients with NTS clinical isolates at MD Anderson Cancer Center from 01/01/00 to 12/31/13. We investigated demographics, site of infection, serogroup, susceptibility, management and outcomes. Wilcoxon ranksum test was used to compare continuous variables and Chi-square or Fisher’s exact tests were used to compare categorical variables, as appropriate. For four-group comparisons, when a significant result (p<0.05) was detected, pairwise comparisons were performed. The α levels of the posthoc pairwise comparisons were adjusted using a sequential Bonferroni method to control type I error. All tests except those in the pairwise comparisons were two-sided tests with a significance level of 0.05. Data analyses were performed using SAS version 9.3 (SAS Institute Inc., Cary, NC). Conclusions/ Discussion To our knowledge, this study is the largest case series in cancer patients. Two thirds had hematologic malignancy and most of them had received immunosuppressive agents. CLSI M100 S23 (2012) revised breakpoint of ciprofloxacin from ≤1.0 to ≤0.06. In our study, 96% was sensitive with old breakpoint, which decreased to 92% with current criteria. Antibiotic prophylaxis may not prevent salmonellosis since 11 cases developed disease on effective oral antibiotics, presumably due to overwhelming inoculum or lack of adherence. Compared with previous reports [2, 3], our study showed: 1. Higher proportion of bacteremia (49 vs 1-8%) and lower endovascular disease (1 vs 10-20%). 2. Lower infection-related mortality (2 vs 30-40%), perhaps due to earlier initiation of active antibiotics. 3. An unexpectedly high incidence (17%) of UTI and asymptomatic bacteriuria especially in those with urologic abnormalities. References 1)Mandal BK, et al. Bacteraemia in salmonellosis: a 15 year retrospective study from a regional infectious diseases unit. BMJ. 1988 Nov 12;297(6658):1242-3. 2)Dhanoa A, et al. Non-typhoidal Salmonella bacteraemia: epidemiology, clinical characteristics and its' association with severe immunosuppression. Ann Clin Microbiol Antimicrob. 2009 May 18;8:15. 3)Li CW, et al. Non-typhoidal Salmonella bacteremia among adults: an adverse prognosis in patients with malignancy. J Microbiol Immunol Infect. 2012 Oct;45(5):343-9. Non-typhoidal Salmonella Infections in Cancer Patients Nobuyoshi Mori, MD, Ariel Szvalb, MD, Javier Adachi, MD, Ying Jiang, MS, Victor Mulanovich, MD Department of Infectious Diseases, Infection Control & Employee Health, University of Texas MD Anderson Cancer Center
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