title: Invasive infection with multidrug-resistant Salmonella enterica serotype typhimurium definitive type 104 among HIV-infected adults.
abstract: BACKGROUND
  Multidrug-resistant Salmonella enterica serotype Typhimurium definitive type 104 (MRDT104), with resistance to at least ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, and tetracycline (R-type ACSSuT), was first detected in the United States in 1985, and the prevalence increased to account for nearly 7% of Salmonella infections in 1998.
  
  
  METHODS
  A retrospective study of S. Typhimurium infections in an urban health care system assessed whether infection with an antibiotic-resistant strain--and specifically MRDT104--was associated with invasive disease or HIV infection. Sixty cases of S. Typhimurium infection were identified.
  
  
  RESULTS
  Of the 50 isolates available for analysis, 30 (60%) were MRDT104. Pathogens were isolated from blood in 25 (83%) of 30 patients infected with MRDT104, compared with 10 (50%) of 20 patients who were infected with non-MRDT104 strains (P = .01). Among isolates obtained from 32 HIV-infected patients, 19 (95%) of 20 MRDT104 isolates were from blood specimens, compared with 8 (66%) of 12 non-MRDT104 isolates (P = .05).
  
  
  CONCLUSIONS
  MRDT104 accounted for the majority of S. Typhimurium infections in this patient population, and MRDT104 infections were more invasive than non-MRDT104 infections, particularly in HIV-infected persons.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Emory University, Atlanta, Georgia, USA.
authors.forename: Tamara L
authors.initials: TL
authors.lastname: Fisk
authors.forename: Brita E
authors.initials: BE
authors.lastname: Lundberg
authors.forename: Jodie L
authors.initials: JL
authors.lastname: Guest
authors.forename: Susan
authors.initials: S
authors.lastname: Ray
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Barrett
authors.forename: Ben
authors.initials: B
authors.lastname: Holland
authors.forename: Karen
authors.initials: K
authors.lastname: Stamey
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Angulo
authors.forename: Monica M
authors.initials: MM
authors.lastname: Farley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001434:Bacteriophage Typing; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012480:Salmonella Infections / Q000209:etiology* / Q000382:microbiology*; D012486:Salmonella typhimurium / Q000145:classification / Q000302:isolation & purification*; D012703:Serotyping
chemical_list: D000900:Anti-Bacterial Agents