A retrospective study of secondary bacteraemia in hospitalised adults with community acquired non-typhoidal Salmonella gastroenteritis

• Published in: BMC infectious diseases Vol. 13; no. 1; p. 107
• Main Authors: Parry, Christopher M, Thomas, Sherine, Aspinall, Esther J, Cooke, Richard P D, Rogerson, Stephen J, Harries, Anthony D, Beeching, Nicholas J
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 27.02.2013; BioMed Central
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; Adults; Aged; AIDS; Analysis of Variance; Bacteremia; Bacteremia - epidemiology; Bacteremia - microbiology; Bacteriology; Blood; Cardiovascular disease; Chronic diseases; Chronic illnesses; Colleges & universities; Community-Acquired Infections - epidemiology; Community-Acquired Infections - microbiology; Complications and side effects; Female; Gastroenteritis; Gastroenteritis - epidemiology; Gastroenteritis - microbiology; Health aspects; Heart; Hospitalization; Hospitals; Human immunodeficiency virus; Humans; Hypertension; Infections; Male; Medical research; Medicine; Medicine, Experimental; Middle Aged; Patient outcomes; Patients; Retrospective Studies; Salmonella; Salmonella Infections - epidemiology; Salmonella Infections - microbiology; United Kingdom - epidemiology; United Kingdom; Glasgow Scotland; United Kingdom > UK
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/1471-2334-13-107

The clinical significance of bacteraemia secondary to non-typhoidal Salmonella (NTS) gastroenteritis in hospitalised adults is uncertain. Adults admitted to a hospital in Liverpool, UK, with NTS gastroenteritis were identified using hospital discharge data and laboratory records. Patients with known HIV infection were excluded. Risk factors for a complicated or fatal course were determined. Between 1982 and 2006 inclusive, 633 adults were identified. Serovars causing infection included Enteritidis (46.6%), Typhimurium (27.6%) and Virchow (4.9%). A blood culture was taken in 364 (57.5%) patients who were generally sicker than those who were not cultured. Bacteraemia was detected in 63 (17.3%) patients who had blood cultures taken (63/633 (10.0%) of all patients). Bacteraemia was more common in those aged ≥ 65 years (p < 0.001) and in those aged < 65 years who had an underlying chronic disease. A complicated course occurred in 91 (25.0%) patients who had had a blood culture taken (148/633 (23.4%) of all patients). Independent factors associated with a complicated or fatal course among the patients investigated with a blood culture were bacteraemia (Adjusted Odds Ratio 5.34, 95% CI 2.86-9.95); new onset confusion or coma (AOR 4.80, 95% CI 1.91-12.07); prolonged symptoms prior to admission (AOR 2.48, 95% CI 1.44-4.27); dehydration (AOR1.90, 95% CI 1.07-3.38); and absence of fever (AOR 0.56, 95% CI 0.32-0.95). The 30 day attributable case fatality for all patients was 1.5%. In this study secondary bacteraemia, as well as other clinical factors, was independently associated with a complicated or fatal course in non-HIV infected adults admitted to hospital with NTS gastroenteritis.