International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2002
Risk factors for mortality caused by nontyphoidal Salmonella sp. in children.
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Rosanova Maria Teresa, Paganini Hugo, Bologna Rosa, Lopardo Horacio, Ensinck Gabriela
Аннотация
OBJECTIVE: To identify the risk factors for mortality in extraintestinal nontyphoidal Salmonella (NTS) infections in infants and children.
METHODS: We performed a retrospective analysis of 107 patients with at least one nonfecal culture for NTS seen from January 1988 to December 1995.
RESULTS: The median age was 12 (range 1-216) months. Malnutrition was found in 55 patients (51%), and 22 (20%) displayed severe features (weight loss >40%). Seventy-two patients (67%) had previously been hospitalized, and 59 (55%) had received antibiotics during the month before admission. Fever (85%) and diarrhea (56%) were the most frequent clinical manifestations. Nineteen children (18%) had leukopenia. Forty-nine patients (46%) had only bacteremia, 33 (31%) bacteremia with focal infections, and 25 (23%) focal infections with negative blood cultures. Forty-seven strains (44%) were multiresistant, and 40 of them were nosocomially acquired. Eight patients (7%) had received inappropriate antibiotic treatment, and two of them died. Thirteen (12%) children died. Age, underlying disease, previous admission, previous antibiotic therapy, type of infection, susceptibility of the strains and inappropriate antibiotic treatment were not statistically significant risk factors for mortality. A logistic regression analysis selected the following variables as independently influencing outcome: malnutrition (P<0.01), leukopenia (P<0.002) and presence of diarrhea (P<0.02).
CONCLUSIONS: Children with extraintestinal infections by NTS with leukopenia, malnutrition and presence of diarrhea have a higher risk of death.
METHODS: We performed a retrospective analysis of 107 patients with at least one nonfecal culture for NTS seen from January 1988 to December 1995.
RESULTS: The median age was 12 (range 1-216) months. Malnutrition was found in 55 patients (51%), and 22 (20%) displayed severe features (weight loss >40%). Seventy-two patients (67%) had previously been hospitalized, and 59 (55%) had received antibiotics during the month before admission. Fever (85%) and diarrhea (56%) were the most frequent clinical manifestations. Nineteen children (18%) had leukopenia. Forty-nine patients (46%) had only bacteremia, 33 (31%) bacteremia with focal infections, and 25 (23%) focal infections with negative blood cultures. Forty-seven strains (44%) were multiresistant, and 40 of them were nosocomially acquired. Eight patients (7%) had received inappropriate antibiotic treatment, and two of them died. Thirteen (12%) children died. Age, underlying disease, previous admission, previous antibiotic therapy, type of infection, susceptibility of the strains and inappropriate antibiotic treatment were not statistically significant risk factors for mortality. A logistic regression analysis selected the following variables as independently influencing outcome: malnutrition (P<0.01), leukopenia (P<0.002) and presence of diarrhea (P<0.02).
CONCLUSIONS: Children with extraintestinal infections by NTS with leukopenia, malnutrition and presence of diarrhea have a higher risk of death.