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QJM Advance Access published online on October 3, 2005
QJM, doi:10.1093/qjmed/hci126
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© The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received March 17, 2005
Revised August 13, 2005

Original paper

Risk factors for bacteraemia and endovascular infection due to non-typhoid salmonella: a reappraisal

R.-B. Hsu 1 and F.-Y. Lin 1*

1 From the Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, ROC

* To whom correspondence should be addressed.
F.-Y. Lin, E-mail: fylin1{at}ha.mc.ntu.edu.tw


  Abstract

Background: Endovascular infections are rare complications of non-typhoid salmonellosis. The diagnosis is frequently not established until the infection is advanced. It is important to identify high-risk patients and treat them as early as possible.

Aim: To identify risk factors for bacteraemia and endovascular infection in patients with non-typhoid salmonellosis.

Design: Retrospective study.

Setting: A single tertiary-care hospital in Taiwan.

Methods: Data were collected by retrospective chart review. Log-logistic regression modelling was used to identify independent risk factors for bacteraemia and endovascular infection. We analysed the characteristics of patients with gastroenteritis vs. those with bacteraemia, and of bacteraemic patients with vs. without endovascular infection.

Results: Between 1984 and 2004, there were 373 adult cases of non-typhoid salmonellosis. There were 76 intestinal Salmonella infections, 290 bloodstream infections (including 47 endovascular infections), and 7 extra-intestinal non-bacteraemic infections. The independent positive predictors of bacteraemia were systemic lupus erythematosus, liver cirrhosis, HIV infection, and solid organ cancers. The only independent positive predictor of endovascular infection was atherosclerosis. The independent negative predictors of endovascular infection were solid organ cancers and immunodeficiency.

Discussion: Risk factors for atherosclerosis predisposed our patients with bacteraemia to endovascular infection. Although immunodeficiency predisposed patients to bacteraemia, it was associated with a low incidence of endovascular infection.


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