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

Parry, Christopher M, Thomas, Sherine, Aspinall, Esther J, Cooke, Richard PD, Rogerson, Stephen J, Harries, Anthony D and Beeching, Nicholas ORCID: https://orcid.org/0000-0002-7019-8791 (2013) 'A retrospective study of secondary bacteraemia in hospitalised adults with community acquired non-typhoidal Salmonella gastroenteritis'. BMC Infectious Diseases, Vol 13, e107.

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Abstract

Background

The clinical significance of bacteraemia secondary to non-typhoidal Salmonella (NTS) gastroenteritis in hospitalised adults is uncertain.

Methods

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.

Results

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%.

Conclusions

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.

Item Type:	Article
Additional Information:	The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-2334/13/107
Subjects:	WC Communicable Diseases > WC 20 Research (General) WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 240 Bacteremia. Sepsis. Toxemias WC Communicable Diseases > Infection. Bacterial Infections > Enteric Infections > WC 269 Salmonella infections WI Digestive System > WI 140 Diseases (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1186/1471-2334-13-107
Depositing User:	Lynn Roberts-Maloney
Date Deposited:	06 Mar 2015 14:06
Last Modified:	09 Sep 2019 06:27
URI:	https://archive.lstmed.ac.uk/id/eprint/4991

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