Urinary tract infection due to non-typhoidal Salmonella: report of 19 cases

Abstract

Objectives: Urinary tract infection (UTI) caused by non-typhoidal Salmonella (NTS) is rare. The aims were to know the frequency and clinical characteristics of this infection in our area.

Patients and methods: We performed a retrospective analysis of patients with bacteriuria due to NTS diagnosed in our hospital from January 1990 to December 2005.

Results: Nineteen patients with bacteriuria caused by NTS were diagnosed, representing 0.07% of the UTIs diagnosed in our area over the same period. The mean age was 62.5 years old. Eighteen patients (94.7%) had symptoms of UTI (12, cystitis; 6, pyelonephritis), and 1 remained asymptomatic. Fourteen patients (73.6%) had chronic diseases; diabetes mellitus was present in 8 of them (42.1%) and 7 patients (36.8%) were undergoing immunosuppressor treatment. Eight patients (42.1%) had urologic abnormalities. S. enteritidis was the most common serotype isolated (16 cases). Eleven patients required antibiotic treatment over 2 or more weeks. Four patients had recurrent Salmonella UTIs (22.2%), and in 2 of them recurrence occurred after prolonged treatment during 3.5 and 5 weeks, respectively.

Conclusions: UTI due to NTS was predominantly observed in elderly patients with underlying diseases, especially diabetes mellitus, urologic abnormalities and immunosuppression. Prolonged antibiotic treatment should be considered due to the high frequency of complicating conditions, although the infection can be recurrent despite prolonged treatment.