Non-typhoidal Salmonella bacteraemia in elderly patients: an increased risk for endovascular infections, osteomyelitis and mortality

Abstract

Non-typhoidal Salmonella (NTS) is a common pathogen causing foodborne infections, bacteraemia, and extra-intestinal focal infections (EFIs) in humans. The study compares the clinical characteristics of elderly patients with NTS bacteraemia with those of young adults. Of 272 adults with NTS bacteraemia identified in this study, 162 (59·6%) were aged ⩾55 years. EFIs were observed in 36% of the 162 patients. The most common EFIs in the elderly patients (⩾55 years) was mycotic aneurysm, followed by pulmonary infections and bone/joint infections. Elderly patients more often had chronic heart, lung, renal and malignant diseases, had more EFIs, and a higher 30-day mortality rate. Independent factors of 30-day mortality in elderly patients were solid-organ tumour [adjusted odds ratio (aOR) 4·4, P=0·003], mycotic aneurysm (aOR 3·7, P=0·023) and shock (aOR 12·1, P<0·0001). HIV infection, autoimmune diseases, and receipt of immunosuppressive therapy were more often observed in young patients.

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

“…This is consistent with reports that NTS bacteremia may follow more commonly in patients who are immunocompromised or have comorbid diseases, and mortality generally rises with increasing age (14). A higher rate of mortality in the elderly is thought to be due to the presence of several comorbidities (21).…”

Antimicrobial use in critically ill horses

“…Bacteremia and extraintestinal infections secondary to Salmonella gastroenteritis are associated with a more complicated disease course and increased fatality in people . Elderly people, those with malignancies, and immunocompromised children and adults are at increased risk of developing bacteremia and have higher mortality rates than otherwise healthy patients with gastrointestinal tract infections. Despite this, no consensus exists as to whether antimicrobial prophylaxis should be given to high‐risk patients with enteric salmonellosis with the aim of preventing bacteremia and extraintestinal infections …”

83-jähriger Patient mit Salmonellenbakteriämie und Infekt-getriggertem Sweet-Syndrom

“…-infizierte Aneurysmen, Pneumonien und Knochen-/ Weichteilinfektionen hervorrufen. Aufgrund bereits oft vorbestehender chronischer und maligner Erkrankungen ist die 30-Tage-Letalitätsrate höher als bei jüngeren Patienten [3]. Malignome stellen einen nachteiligen prognostischen Faktor bei einer enteritischen Salmonellenbakteriämie dar [8].…”