Invasive infection with multidrug-resistant Salmonella enterica serotype typhimurium definitive type 104 among HIV-infected adults.
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.
Fisk
Tamara L
TL
Department of Medicine, Division of Infectious Diseases, Emory University, Atlanta, Georgia, USA.
Lundberg
Brita E
BE
Guest
Jodie L
JL
Ray
Susan
S
Barrett
Timothy J
TJ
Holland
Ben
B
Stamey
Karen
K
Angulo
Frederick J
FJ
Farley
Monica M
MM
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
D000900:Anti-Bacterial Agents