Magnitude of bacteraemia is associated with increased mortality in non‐typhoid salmonellosis: a one‐year follow‐up study

Gradel, Kim Oren; Dethlefsen, Claus; Schønheyder, Henrik Carl; Nielsen, Henrik

doi:10.1111/j.1600-0463.2008.00886.x

Cited by 9 publications

(6 citation statements)

References 31 publications

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“…NTS bacteremia in admitted hospital patients was closely associated with cardiovascular, pulmonary, and genitourinary comorbidities and specific conditions, such as diabetes, primary hypertension, and acute kidney failure. This is consistent with reports that NTS bacteremia may follow more commonly in patients who are immunocompromised or have comorbid diseases, and mortality generally rises with increasing age (14). A higher rate of mortality in the elderly is thought to be due to the presence of several comorbidities (21).…”

Section: Discussionsupporting

confidence: 90%

“…Colistin is being used as a last-resort drug to treat infections caused by multidrug-resistant (MDR) Gram-negative bacteria. Colistin resistance is low in Salmonella spp., with some serovars having inherent chromosomal resistance to colistin; however, ongoing surveillance for transmissible resistance is vital (14).…”

Section: Discussionmentioning

confidence: 99%

“…The development of extraintestinal infections is associated with more severe septic manifestations, longer hospital stays, longer duration of antimicrobial therapy, and a higher rate of mortality. In adults, NTS bacteremia poses significant health threats because affected patients usually have underlying diseases (14,15).…”

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confidence: 99%

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Epidemiology and Outcomes of Nontyphoidal Salmonella Bacteremias from England, 2004 to 2015

et al. 2019

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Nontyphoidal Salmonella (NTS) bacteremia causes hospitalization and high morbidity and mortality. We linked Gastrointestinal Bacteria Reference Unit (GBRU) data to the Hospital Episode Statistics (HES) data set to study the trends and outcomes of NTS bacteremias in England between 2004 and 2015. All confirmed NTS isolates from blood from England submitted to GBRU between 1 January 2004 and 31 December 2015 were deterministically linked to HES records. Adjusted odds ratios (AOR), proportions, and confidence intervals (CI) were calculated to describe differences in age, sex, antibiotic resistance patterns, and serotypes over time. Males, neonates, and adults above 65 years were more likely to have NTS bacteremia (AOR, 1.54 [95% CI, 1.46 to 1.67]; 2.57 [95% CI, 1.43 to 4.60]; and 3.56 [95% CI, 3.25 to 3.90], respectively). Proportions of bacteremia increased from 1.41% in 2004 to 2.67% in 2015. Thirty-four percent of all blood isolates were resistant to a first-line antibiotic, and 1,397 (56%) blood isolates were linked to an HES record. Of the patients with NTS bacteremia, 969 (69%) had a cardiovascular condition and 155 (12%) patients died, out of which 120 (77%) patients were age 65 years and above. NTS bacteremia mainly affects older people with comorbidities placing them at increased risk of prolonged hospital stay and death. Resistance of invasive NTS to first-line antimicrobial agents appeared to be stable in England, but the emergence of resistance to last-resort antibiotics, such as colistin, requires careful monitoring.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Epidemiology and Outcomes of Nontyphoidal Salmonella Bacteremias from England, 2004 to 2015

et al. 2019

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“…Our stratification analysis showed patients without hypertension, diabetes, hyperlipidemia, coronary artery disease, cerebrovascular accident, chronic kidney disease, COPD, chronic liver diseases, vasculitis, or IBD would be at higher risk of NTS infection after bowel resection. We might explain this phenomenon by the fact that affected patients usually have underlying diseases, so that NTS poses significant health threats 4 . If underlying covariates did not exist, bowel resection would play a significant predisposing factor of NTS infection.…”

Section: Discussionmentioning

confidence: 99%

The association between bowel resection and the risk of nontyphoidal salmonella infection: a nationwide propensity score-matched cohort study

Yang

Juang

Hung

et al. 2021

Sci Rep

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Nontyphoidal salmonella (NTS) infection has a high mortality rate. Bowel resections affect gut microbiota and immune function, and the association between bowel resection and NTS infection in human beings has not been addressed. We conducted a nationwide propensity score (PS)-matched cohort study to clarify this association. Data from the Longitudinal Health Insurance Database of Taiwan were used to establish a case-cohort with bowel resections from 2000 to 2013. Informed consent was waived by the Institutional Review Board of China Medical University Hospital (CMUH104-REC2-115) because all personal identifying information used had been de-identified. Each case was matched with one control without any bowel resection according to age, gender, index date, and propensity score (PS). Cumulative incidences of and hazard ratios (HRs) for NTS infection development were analyzed. The incidence of NTS infection was greater in patients with a bowel resection than in the control group (2.97 vs. 1.92 per 10,000 person-years), with an adjusted hazard ratio (aHR) of 1.64 (95% CI = 1.08–2.48). The incidence of NTS infection increased significantly for cases with small bowel resections and right hemicolectomies. Age (31–40 and > 50 years), hypertension, chronic kidney disease, chronic obstructive pulmonary disease, and autoimmune diseases were significant risk factors of NTS infection. Stratification analysis revealed that patients without comorbidities were prone to NTS infection after bowel resections. The increased risk of developing NTS infection could be related to the bowel resection. Specific age groups and comorbidities also contribute to increased risk of NTS infection.

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“… 20 When treated with adequate antimicrobials, the mortality in hospitalised cases of typhoid fever is 2–5% compared with 20–30% in other types of Gram-negative sepsis. 21 , 22 A severe and fatal outcome in other Gram-negative bacteraemias has been associated with high counts in the blood, 23 , 24 but the relationship between the development of severe disease and blood bacterial counts has not been fully explored in typhoid fever. 16 , 18 The bacterial counts in bone marrow are on average 10-fold higher than in blood in typhoid fever and the organisms are frequently intracellular.…”

Section: Introductionmentioning

confidence: 99%

Quantitative bacterial counts in the bone marrow of Vietnamese patients with typhoid fever

Bay

Wain

Phuong

et al. 2022

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Background Bone marrow culture (BMC) is the reference standard for typhoid fever diagnosis. We studied the additional yield of BMC over blood culture (BC) and the relationship between quantitative BMC counts and severe disease. Methods Hospitalised Vietnamese patients with suspected typhoid fever were prospectively investigated with a BC, BMC, faecal culture and quantitative BMC counts. Results Salmonella typhi was isolated in 195 of 231 patients: from BC and BMC in 144 (73.8%), from BMC alone in 33 (16.9%), from BC alone in 12 (6.2%) and from faeces alone in 6 (3.1%). In 167 patients the median extracellular count of S. typhi was 2.5 cfu/mL (interquartile range [IQR] 0–10) and the intracellular count was 10.5 cfu/mL (IQR 2–42) with a ratio of 1.3 bacteria/cell (IQR 0.6–2.5). The median count of intracellular bacteria in 24 patients with severe disease was 46 bacteria/cell (IQR 9–105) compared with 6.5 bacteria/cell (IQR 2–34) in 143 with non-severe disease (p=0.005). The intracellular BMC count was negatively correlated with the peripheral white cell count and positively correlated with hepatomegaly, splenomegaly, aspartate transaminase, a positive BC and the fever clearance time following treatment with azithromycin, ofloxacin or a combination of the two. Conclusions BMC gave a moderate additional yield over BC. Intracellular BMC counts may reflect the bacterial load in typhoid fever.

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Magnitude of bacteraemia is associated with increased mortality in non‐typhoid salmonellosis: a one‐year follow‐up study

Cited by 9 publications

References 31 publications

Epidemiology and Outcomes of Nontyphoidal Salmonella Bacteremias from England, 2004 to 2015

Epidemiology and Outcomes of Nontyphoidal Salmonella Bacteremias from England, 2004 to 2015

The association between bowel resection and the risk of nontyphoidal salmonella infection: a nationwide propensity score-matched cohort study

Quantitative bacterial counts in the bone marrow of Vietnamese patients with typhoid fever

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