Non-typhoidal Salmonella bacteremia in adults.

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. METHODS 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. RESULTS 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). CONCLUSIONS 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.