title: Risk factors for mortality caused by nontyphoidal Salmonella sp. in children.
abstract: 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.
authors.affiliation: Epidemiology and Infectious Disease Department, Hospital de Pediatría, Buenos Aires, Argentina. mrosa@intramed.net.ar
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Rosanova
authors.forename: Hugo
authors.initials: H
authors.lastname: Paganini
authors.forename: Rosa
authors.initials: R
authors.lastname: Bologna
authors.forename: Horacio
authors.initials: H
authors.lastname: Lopardo
authors.forename: Gabriela
authors.initials: G
authors.lastname: Ensinck
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000382:microbiology / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000150:complications; D005260:Female; D006801:Humans; D007223:Infant; D007970:Leukopenia / Q000150:complications; D016015:Logistic Models; D008297:Male; D009748:Nutrition Disorders / Q000150:complications; D012307:Risk Factors; D012475:Salmonella / Q000145:classification / Q000302:isolation & purification*; D012480:Salmonella Infections / Q000382:microbiology / Q000401:mortality* / Q000503:physiopathology