Correlates of non-typhoidal Salmonella bacteraemia: A case–control study. (April 2019) - Katz, David
Highlights: The correlates of non-typhoidal Salmonella (NTS) bacteremia differed by age. In children, a recent emergency room visit was positively related to NTS bacteremia. In adults, comorbidity increased the likelihood of NTS bacteremia. Haemoglobin level was inversely related to NTS bacteremia. Steroid therapy, indicating immunosuppression, increased the risk of NTS bacteremia. Abstract: Objective: Limited up-to-date evidence exists on host-related characteristics of non-typhoidal Salmonella (NTS) bacteraemia in high-income countries. Correlates of NTS bacteraemia in Israel were examined in this study. Methods: A case–control study was conducted using the medical records of patients hospitalized with NTS bacteraemia in Jerusalem during 1997–2016 ( n = 106; 57 children, 49 adults). Two control groups were included: (1) randomly selected controls ( n = 101), who were patients hospitalized due to bacteraemia with other pathogens; (2) patients with salmonellosis without bacteraemia ( n = 112). Age-stratified logistic regression models were constructed. Results: In children, a recent emergency room visit was associated with an increased likelihood of NTS bacteraemia. In adults, the likelihood of NTS bacteraemia versus salmonellosis increased in relation to Charlson comorbidity score (adjusted odds ratio (aOR) 1.29, 95% confidence interval (CI) 1.00–1.66, for each 1-point increase in the score), while an inverse association was found with haemoglobin level (aOR 0.72, 95% CI 0.54–0.95). Steroid therapy increased the likelihood of NTS bacteraemia compared to patients with bacteraemia due to other pathogens (aOR 5.22, 95% CI 1.01–26.93). Conclusions: In children, NTS bacteraemia was probably present at their prior emergency room visit. A high comorbidity burden increased the likelihood of bacteraemia in adults with Salmonella infection, while haemoglobin level might be protective.