Infections caused by non-Typhi serovars of Salmonella at the
Infectious Diseases Clinic of the University Hospital Brno in 2011–2013


Authors: P. Polák 1,2;  M. Vrba 3;  Z. Bortlíček 4;  J. Juránková 3,5;  M. Freibergerová 1;  P. Husa 1,2;  J. Kamelander 6;  M. Dastych 1
Authors‘ workplace: Lékařská fakulta Masarykovy univerzity Brno 1;  Klinika infekčních chorob, Fakultní nemocnice Brno 2;  Oddělení klinické mikrobiologie, Fakultní nemocnie Brno 3;  Ústav biostatistiky a analýz, Masarykova univerzita Brno 4;  Katedra laboratorních metod, Lékařská fakulta Masarykovy univerzity Brno 5;  Oddělení klinické hematologie, Fakultní nemocnice Brno 6;  Oddělení klinické biochemie, Fakultní nemocnice Brno 7
Published in: Epidemiol. Mikrobiol. Imunol. 63, 2014, č. 4, s. 289-296
Category: Review articles, original papers, case report

Overview

Introduction:
The aim of the study is to describe the basic clinical, laboratory, and microbiological characteristics in adult patients with salmonellosis hospitalized at the Infectious Diseases Clinic of the University Hospital Brno in 2011–2013.

Materials and methods:
A retrospective analysis of clinical and laboratory parameters of 161 patients hospitalized at the Infectious Diseases Clinic of the University Hospital Brno from 1 January 2011 to 31 December 2013.

Results:
Invasive salmonellosis was seen in 22.4 % of the study group. The overall lethality rate reached 3.1 %. Treatment with antibiotics was used in 93.8% of patients. Transient mild to moderate leukocytopenia was reported in 4.3 % of patients and thrombocytopenia in 9.3% of patients. Transient changes in white blood cells as well as in the thrombocyte count were not clinically important. Long-term treatment with proton pump inhibitors is a risk factor for salmonellosis (p = 0.128), but not for invasive salmonellosis. Long-term use of opioids (p = 0.003) and/or acetylsalicylic acid (p = 0.015) is a risk factor for invasive salmonellosis. Other risk factors for invasive disease are: age over 70 years (p = 0.011), arterial hypertension (p = 0.004), disease duration of less than three days (p = 0.006), serum creatinine level above 250 μmol/l (p = 0.01), peripheral leucocyte count above 12 x 109/l (p=0.001), and body temperature above 38 °C (p = 0.001). Hypokalemia does not represent a risk factor for invasive salmonellosis.

Conclusions:
Aged patients on long-term opioids or acetylsalicylic acid, with disease duration of less than three days, and meeting the criteria for systemic inflammatory response syndrome are at the highest risk for invasive salmonellosis. Empirical antibiotics are prescribed too often and the treatment is not properly de-escalated.

Keywords:
almonellosis – antibiotic resistance – sepsis – carriage


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