Clinical manifestations of non-typhoid Salmonella bacteremia in southern Taiwan

Abstract

Abstract Purpose: This study is conducted to investigate the clinical characteristics of patients with bacteremia caused by non-typhoid Salmonella (NTS). Methods: Patients with bacteremia caused by NTS during the period 2010 to 2014 were identified from a computerized database of a regional hospital in southern Taiwan. The medical records of these patients were retrospectively reviewed. Results: A total of the 85 patients with NTS bacteremia were identified and 66% of them were classified as elderly patient with age ≥ 65 years. In addition to 30 (35.3%) cases of primary bacteremia, the most common source of secondary infection is acute gastroenteritis (n = 29, 34.1%). Group B was the most common NTS serogroup, followed by group D and C. More than 75% of the cases of NTS bacteremia developed in patients with immunocompromised conditions, which was defined as the patient had any one of the following conditions – cancer, liver cirrhosis, diabetes mellitus, end-stage renal disease, connective tissue diseases, HIV infections, and receiving immunosuppressant or steroid. Clinical outcomes, including rate of ICU admission, acute respiratory failure, and mortality were 21.2%, 14.1%, and 11.8%, respectively. In-hospital mortality was significantly associated with shock as the initial presentation (odds ratio, 5.25, 95% confidence interval: 1.31-20.97). 94-98% of clinical isolates were susceptible to third-generation cephalosporin, but ciprofloxacin resistant rate was 17.6%. Conclusions: NTS bacteremia is not uncommon, especially in immunocompromised and elderly patients, and shock as the initial presentation is significant risk factors for mortality of patients with NTS bacteremia. Third-generation cephalosporin remains good in vitro activity against NTS.