Non-typhoidal Salmonella bacteremia among adults: An adverse prognosis in patients with malignancy

作者：Li Chia Wen; Chen Po Lin; Lee Nan Yao; Lee Hsin Chun; Chang Chia Ming; Lee Ching Chi; Ko Wen Chien^*

来源：Journal of Microbiology, Immunology, and Infection, 2012, 45(5): 343-349.

DOI：10.1016/j.jmii.2011.12.015

• Malignancy
• Mortality
• Non-typhoidal
• Salmonella bacteremia

Background: Clinical information about non-typhoidal Salmonella (NTS) bacteremia in patients with malignancy has rarely been described. This study investigated clinical characteristics and prognostic variables of patients with malignancy while complicated with NTS bacteremia. %26lt;br%26gt;Methods: The study included demographic data, clinical information, and outcome in adults (%26gt;= 18 years old) with and without malignancy complicated with NTS bacteremia at a medical center from 2000 to 2009. %26lt;br%26gt;Results: There were 206 patients with HIS bacteremia. The serogroups of NTS isolates included group B (40.2%), group D (30.9%), group C (26.5%), and group E (1.5%). Extraintestinal infections were noted in 66 (32.4%) patients and were mainly endovascular (26/206, 12.7%) or pleuropulmonary (17/206, 8.3%) infections. On multivariate analysis, independent factors for in-hospital mortality included shock (odds ratio [OR] 9.13; 95% confidence interval [Cl] 3.81 21.83; p %26lt; 0.001), malignancy (OR 8.42; 95% CI 3.12-22.71; p %26lt; 0.001), and acute renal failure (OR 2.63; 95% CI 1.11-6.22; p = 0.028). Different clinical presentations and outcome were noted in 74 (36.2%) patients with malignancy and 130 without malignancy. The former had more leucopenia and thrombocytopenia at initial presentation and fewer extraintestinal infections (20.2% vs. 39.2%, p = 0.005), endovascular infections (2.7% vs. 18.5%; p = 0.002), and serovar Choleraesuis (10.8% vs. 27.7%; p = 0.005). An elevated in-hospital mortality rate was noted in patients with malignancy compared to those without malignancy (40.5% vs. 17.7%, p %26lt; 0.001). Among patients with malignancy, multivariate analysis revealed that shock was the only independent factor associated with in-hospital mortality (OR 7.52; 95% CI, 2.38-23.80; p = 0.001). %26lt;br%26gt;Conclusion: Malignancy is an adverse prognostic factor in patients with NTS bacteremia. Food safety in patients with malignancy should be emphasized to prevent salmonellosis.

• 出版日期2012-10