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High-throughput Assay to Phenotype Salmonella enterica Typhimurium Association, Invasion, and Replication in Macrophages
Published on: August 11, 2014
Factors Associated with Multi-Drug-Resistant Non-Typhoidal Salmonella in the Invasive Disease, Thailand
Kitchawan Hengkrawit1, Chidchanok Tangjade2
1Pediatric Infectious Disease Unit, Department of Pediatrics, Panyananthaphikkhu Chonprathan Medical Center, Srinakarinwirot University, Nonthaburi, Thailand.
Purpose:
Invasive non-typhoidal Salmonella disease, iNTS is a major global health concern, especially multi-drug resistant non-typhoidal Salmonella, MDR-NTS. Information about risk factors of MDR-NTS in the invasive disease patient group was limited. This study aimed to identify those risk factors.
Methods:
This retrospective study examined data from patients who had non-typhoidal Salmonella, NTS infection, from 10 hospitals between June 2011 and June 2020. The multivariate regression analysis included demographic data, clinical data, culture reports, and antimicrobial susceptibility.
Results:
A total of 166 patients were invasive salmonellosis. where the median age was 8.3 years (IQR 1.8-79). 52% were the under-15-years-old group. Most of the patient data, 64.5% (107/166), was from a tertiary hospital. The majority of cases were bacteremia 95.7% (159/166). Serogroup C was the most common serogroup (39%). MDR-NTS was present in 68.8% (95% CI 7.17-11.06) of patients. Univariate analysis showed that onset of illness >3 days PTA (p=0.11), age over 60 years old (0.014), diabetic (p=0.002), or serogroup C infection (p=0.43) were significant factors for MDR-NTS infection. Multivariate analysis showed that the onset of symptoms more than 3 days before admission (p=0.001), and age over 60 years were significant factors. The patient who had white blood cells >15,000 cells/uL (p<0.001), a peak of fever ≥39 C° (p=001), and illness for more than 3 days before admission (p=0.035) were significantly related to invasive infection by multivariate analyses.
Conclusion:
The iNTS patients who were over 60 years old or had onset of illness more than 3 days before admission were associated with MDR-NTS infection. Therefore, the choice of antimicrobials selected must be appropriate for the local prevalence and epidemiology of MDR-NTS including clinical correlation.
Insights
Older adults and delayed hospital admission are key risk factors for severe, multi-drug resistant non-typhoidal Salmonella (MDR-NTS) infections. Early intervention is crucial for better outcomes in invasive salmonellosis patients.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Invasive non-typhoidal Salmonella (iNTS) disease poses a significant global health threat.
- Multi-drug resistant non-typhoidal Salmonella (MDR-NTS) infections are a growing concern, with limited understanding of their specific risk factors in invasive disease.
Purpose of the Study:
- To identify risk factors associated with MDR-NTS in patients with invasive salmonellosis.
- To inform clinical decision-making and public health strategies for combating MDR-NTS.
Main Methods:
- A retrospective study analyzing data from 166 iNTS patients across 10 hospitals (June 2011-June 2020).
- Utilized multivariate regression analysis incorporating demographic, clinical, culture, and antimicrobial susceptibility data.
- Included analysis of patient characteristics such as age, comorbidities, and symptom onset duration.
Main Results:
- MDR-NTS was prevalent in 68.8% of invasive salmonellosis cases.
- Multivariate analysis identified age over 60 years and symptom onset more than 3 days prior to admission as significant risk factors for MDR-NTS.
- Elevated white blood cell counts and high fever were associated with invasive infection.
Conclusions:
- Patients over 60 years old and those with delayed hospital admission (>3 days) are at higher risk for MDR-NTS infection.
- Antimicrobial selection should consider local MDR-NTS prevalence and epidemiology.
- Further research into risk stratification and targeted interventions for iNTS is warranted.
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