Infectious diseases & clinical microbiology · 2026
Invasive Non-typhoidal Salmonella Infections in Adults: Clinical Features, Focal Disease, and Antimicrobial Resistance in a Turkish Tertiary-Care Center.
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Demirbaş Nazife Duygu, Gül Özlem, Koç Edip, Derin Okan, Yıldız-Sevgi Dilek, Bayraktar Banu, Dökmetaş İlyas
Аннотация
OBJECTIVE: Invasive non-typhoidal Salmonella (iNTS) infection may cause severe systemic and focal disease, particularly in patients with comorbidities or immunosuppression. Data on the clinical features and antimicrobial resistance patterns of iNTS infections in Türkiye remain limited. This study aimed to evaluate the clinical and microbiological characteristics of adult patients with microbiologically confirmed iNTS infection at a tertiary-care center in Türkiye.
MATERIALS AND METHODS: This retrospective, single-center case series included adult patients diagnosed with iNTS infection at a tertiary-care hospital in Türkiye between December 2015 and December 2025. Invasive non-typhoidal Salmonella infection was defined as isolation of non-typhoidal Salmonella from blood or normally sterile body sites. Clinical, microbiological, antimicrobial susceptibility, and outcome data were analyzed.
RESULTS: Nine patients with iNTS infection were identified. The median age was 54 years (IQR, 45-68), and 5 patients (55.6%) were male. Underlying comorbidities were present in 8 patients (88.9%), most commonly hypertension, diabetes mellitus, autoimmune diseases, and HIV infection. Gastrointestinal symptoms were observed in only 2 patients (22.2%), whereas 7 patients (77.8%) presented without typical enteric manifestations. Bacteremia was detected in 7 patients (77.8%), and focal invasive infections were identified in 5 patients (55.6%), including spondylodiscitis, septic arthritis, thyroid abscess, and liver abscess. Salmonella enterica serovar Enteritidis was the predominant serovar, identified in 6 isolates (66.7%), while 3 isolates (33.3%) were classified as Salmonella enterica subsp. enterica without further serovar determination. All isolates remained susceptible to third-generation cephalosporins, whereas resistance to ampicillin and ciprofloxacin was detected in 4 (44.4%) and 3 isolates (33.3%), respectively. The median length of hospitalization was 16 days, and 2 patients (22.2%) died during follow-up.
CONCLUSION: Invasive non-typhoidal Salmonella infection may present with heterogeneous and frequently non-enteric manifestations, particularly in adults with significant comorbidities or immunosuppression. The high frequency of focal invasive disease and the relatively high rate of ciprofloxacin resistance in this series highlight the importance of early microbiological diagnosis, evaluation for metastatic infectious foci, and appropriate empirical antimicrobial therapy.
GRAPHICAL ABSTRACT: Graphical Abstract.
MATERIALS AND METHODS: This retrospective, single-center case series included adult patients diagnosed with iNTS infection at a tertiary-care hospital in Türkiye between December 2015 and December 2025. Invasive non-typhoidal Salmonella infection was defined as isolation of non-typhoidal Salmonella from blood or normally sterile body sites. Clinical, microbiological, antimicrobial susceptibility, and outcome data were analyzed.
RESULTS: Nine patients with iNTS infection were identified. The median age was 54 years (IQR, 45-68), and 5 patients (55.6%) were male. Underlying comorbidities were present in 8 patients (88.9%), most commonly hypertension, diabetes mellitus, autoimmune diseases, and HIV infection. Gastrointestinal symptoms were observed in only 2 patients (22.2%), whereas 7 patients (77.8%) presented without typical enteric manifestations. Bacteremia was detected in 7 patients (77.8%), and focal invasive infections were identified in 5 patients (55.6%), including spondylodiscitis, septic arthritis, thyroid abscess, and liver abscess. Salmonella enterica serovar Enteritidis was the predominant serovar, identified in 6 isolates (66.7%), while 3 isolates (33.3%) were classified as Salmonella enterica subsp. enterica without further serovar determination. All isolates remained susceptible to third-generation cephalosporins, whereas resistance to ampicillin and ciprofloxacin was detected in 4 (44.4%) and 3 isolates (33.3%), respectively. The median length of hospitalization was 16 days, and 2 patients (22.2%) died during follow-up.
CONCLUSION: Invasive non-typhoidal Salmonella infection may present with heterogeneous and frequently non-enteric manifestations, particularly in adults with significant comorbidities or immunosuppression. The high frequency of focal invasive disease and the relatively high rate of ciprofloxacin resistance in this series highlight the importance of early microbiological diagnosis, evaluation for metastatic infectious foci, and appropriate empirical antimicrobial therapy.
GRAPHICAL ABSTRACT: Graphical Abstract.