Salmonella Bacteremia in Renal Transplant Recipients

Abstract

Three cases of salmonella bacteremia in renal transplant recipients are reported. Two patients had prolonged salmonella infections with recurring bacteremia. The longest interval between bacteremic relapses was 15 years. 27 cases from the literature of salmonella bacteremia in renal transplant recipients are reviewed. The courses of salmonellosis in renal transplant recipients are more serious than in other non-compromised patients, being complicated by bacteremia in 70% of the cases. Renal transplant recipients have prolonged carrier states and frequent relapses or recurrences of salmonellosis. 45% of the salmonella bacteremias in renal transplant recipients are seen after a high dose methylprednisolone treatment for graft rejection episodes.

Post‐renal transplant infections: single‐center experience from Nigeria

“…In a retrospective study done in Abidjan, Cote d'Ivoire, the prevalence of NTS infection was reported to be 76.1% of salmonella infections, with an MDR rate of 34.1% . Contrary to the NTS infection in normal hosts, such infection in renal transplant recipients manifest as severe infection, mostly as bacteremia and extra‐intestinal foci , and usually occurs when immunosuppression is high (early in the post‐transplant period, or after anti‐rejection therapy) . This report is in keeping with our finding, where both cases presented as gastrointestinal‐related sepsis, of which 1 was diagnosed at 30 days postoperatively.…”

Severe sepsis from a Ciprofloxacin resistant salmonellosis in a kidney transplant recipient

“…Otherwise, in KTR it is rather common to find an extra-intestinal form of salmonellosis, such as meningitis, osteomyelitis, cholangitis and pneumonia (up to 35%), and bacteremia can be demonstrated in 60 to 70% of cases. [9][10][11] Bacteremia from Salmonella sp. is known to bear a high risk of mortality, as described in a series of cases from the Massachusetts General Hospital, in which an outbreak registered in 1990 caused the death of 18% of patients.…”

“…7 Overall, the duration of the infection tends to be longer in KTR, with relapse rates of 43 to 45%, and mortality rates of 5 to 6%. 6,10 A literature review with 37 cases of salmonellosis in KTR identified the species of Salmonella sp. in 35 patients, with predominance of S. typhimurium in 24 cases, S. panama in 3 cases, and S. johannesburg and S. enteritidis in 2 cases each.…”

“…[6][7][8] In immunosuppressed patients, however, it can be more easily associated with bacteremia, and, consequently, to a much worse prognosis. [9][10][11] In this paper, we present a rare case of invasive diarrhea with severe sepsis caused by ciprofloxacin resistant Salmonella sp. in a KTR, and a brief literature review.…”

Zoonoses in Solid-Organ and Hematopoietic Stem Cell Transplant Recipients

“…Bacterial enteric pathogens are common etiologies of foodborne and waterborne illnesses, and may represent contamination from farm animals or other vertebrate animals; they may also be directly transmitted from animals to humans. Transplant recipients have much higher rates of bacteremias due to Salmonellae species-ranging as high as 70%, compared with 3%-4% in normal hosts-and a higher risk of a metastasic focus of infection [129,130]; this is true for other enteric pathogens, as well. Campylobacter species are another group of common zoonotic enteric pathogens in patients who undergo SOT or HSCT.…”