Clinical and prognostic categorization of extraintestinal nontyphoidal Salmonella infections in infants and children.
The study included 172 patients, aged 0-15 years, for whom at least 1 nonfecal, nonurinary specimen was culture-positive for nontyphoidal Salmonella. Ninety-five percent had positive blood cultures. Immunocompromising diseases were found in 19% of 74 infants and 77% of 98 children. Associations between the study factors and outcomes, as localized infection or death, were assessed by logistic regression analysis. Thirty-three patients had localized infections. An adjusted risk factor for development of localized infections was an age of <12 months (P=.003). There were 17 deaths. The case-fatality rates were 43% and 10% for immunocompromised and 5% and 0% for nonimmunocompromised infants and children, respectively. Adjusted risk factors for death were age of <12 months (P=.006), inappropriate antimicrobial therapy (P=.014), meningitis or culture-proven pneumonia due to nontyphoidal Salmonella (P=.004), and immunocompromised status (P<.001). The clinical courses and prognoses for infants and children with extraintestinal infection due to nontyphoidal Salmonella can be categorized into 4 groups according to the characteristics of age (infants vs. children) and host status (immunocompromised vs. nonimmunocompromised).
Sirinavin
S
S
Department of Pediatrics, Ramathibodi Hospital, Bangkok 10400, Thailand. rassr@mahidol.ac.th
Jayanetra
P
P
Thakkinstian
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007958:Leukocyte Count; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D012307:Risk Factors; D012480:Salmonella Infections / Q000276:immunology / Q000401:mortality*