Epidemiology and Outcomes of Nontyphoidal Salmonella Bacteremias from England, 2004 to 2015

Abstract

Nontyphoidal Salmonella (NTS) bacteremia causes hospitalization and high morbidity and mortality. We linked Gastrointestinal Bacteria Reference Unit (GBRU) data to the Hospital Episode Statistics (HES) data set to study the trends and outcomes of NTS bacteremias in England between 2004 and 2015. All confirmed NTS isolates from blood from England submitted to GBRU between 1 January 2004 and 31 December 2015 were deterministically linked to HES records. Adjusted odds ratios (AOR), proportions, and confidence intervals (CI) were calculated to describe differences in age, sex, antibiotic resistance patterns, and serotypes over time. Males, neonates, and adults above 65 years were more likely to have NTS bacteremia (AOR, 1.54 [95% CI, 1.46 to 1.67]; 2.57 [95% CI, 1.43 to 4.60]; and 3.56 [95% CI, 3.25 to 3.90], respectively). Proportions of bacteremia increased from 1.41% in 2004 to 2.67% in 2015. Thirty-four percent of all blood isolates were resistant to a first-line antibiotic, and 1,397 (56%) blood isolates were linked to an HES record. Of the patients with NTS bacteremia, 969 (69%) had a cardiovascular condition and 155 (12%) patients died, out of which 120 (77%) patients were age 65 years and above. NTS bacteremia mainly affects older people with comorbidities placing them at increased risk of prolonged hospital stay and death. Resistance of invasive NTS to first-line antimicrobial agents appeared to be stable in England, but the emergence of resistance to last-resort antibiotics, such as colistin, requires careful monitoring.

Changing Antimicrobial Resistance and Epidemiology of Non-Typhoidal Salmonella Infection in Taiwanese Children

“…This study highlighted that isolates from infants had significantly higher MDR to ampicillin and third-generation cephalosporin than did isolates from other age groups. This is partly explained by the increase in isolates in infants with serotypes since the early 1990s, which have been associated with MDR ( Katiyo et al, 2019 ). This rather unexpected result may be attributed to human-to-human transmissions.…”

“…Non-typhoidal Salmonella (NTS) infection is a global public health concern; it results in a considerable disease burden in both industrialized and developing countries ( Majowicz et al, 2010 ; Kyu et al, 2018 ; Roth et al, 2018 ; Stanaway et al, 2019 ). NTS typically causes self-limiting diarrheal disease and may also result in invasive NTS (iNTS) infection ( Katiyo et al, 2019 ). Approximately 5% of individuals with NTS infection develop invasive diseases, such as bacteremia, meningitis, or septic arthritis, which are especially common in young infants or patients with compromised immune systems ( Hohmann, 2001 ; Feasey et al, 2012 ).…”

Appendectomy and Non-Typhoidal Salmonella Infection: A Population-Based Matched Cohort Study

“…Global non-typhoidal Salmonella (NTS) infection occurs in millions of people annually [ 10 , 11 , 12 , 13 , 14 ]. NTS may cause severe invasive bacteremia or disseminated disease [ 15 , 16 ]. The numbers of host risk factors predispose individuals to NTS [ 17 , 18 ].…”

Epidemiology and Characterization of CTX-M-55-Type Extended-Spectrum β-Lactamase-Producing Salmonella enterica Serovar Enteritidis Isolated from Patients in Shanghai, China

“…In recent decades, the overall antibiotic resistance rate among Salmonella has increased dramatically, from 20–30% in the 1990s to 70% in the early 21st century [ 9 ]. Abuse and inappropriate usage of antibiotics has caused the spread of multidrug resistance (MDR) among pathogen groups [ 10 , 11 ].…”