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. 2012 Oct;45(5):343-9.
doi: 10.1016/j.jmii.2011.12.015. Epub 2011 Dec 29.

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

Chia-Wen Li  1 , Po-Lin Chen, Nan-Yao Lee, Hsin-Chun Lee, Chia-Ming Chang, Ching-Chi Lee, Wen-Chien Ko
Affiliations
Free article

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

Chia-Wen Li et al. J Microbiol Immunol Infect. 2012 Oct.
Free article

Abstract

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.

Methods: The study included demographic data, clinical information, and outcome in adults (≥18 years old) with and without malignancy complicated with NTS bacteremia at a medical center from 2000 to 2009.

Results: There were 206 patients with NTS 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 [CI] 3.81-21.83; p < 0.001), malignancy (OR 8.42; 95% CI 3.12-22.71; p < 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 < 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).

Conclusion: Malignancy is an adverse prognostic factor in patients with NTS bacteremia. Food safety in patients with malignancy should be emphasized to prevent salmonellosis.

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