title: Nontyphoid Salmonella bacteremia in patients with liver cirrhosis.
abstract: BACKGROUND
  Bacteremia is reported to occur in 4% to 9% of hospitalized patients with liver cirrhosis. Escherichia coli and Klebsiella pneumoniae are the most commonly isolated organisms. Only sporadic cases of nontyphoid Salmonella bacteremia are reported in the literature. In this study, we sought to determine the clinical features and prognosis of patients with liver cirrhosis and bacteremia due to nontyphoid Salmonella.
  
  
  METHODS
  Data were collected by retrospective chart review.
  
  
  RESULTS
  From December 1996 to May 2003, we identified 23 patients (18 males, 5 females) with a median age of 58 years. The Child classification for liver cirrhosis was A in 4, B in 9, and C in 10 patients. Solid organ cancers were present in 14 patients: hepatocellular carcinoma in 13 patients and gastric carcinoma in 1 patient. Hospital death occurred in 11 patients (48%): 7 died of sepsis and 4 of hepatic failure. Using a logistic regression model, the independent risk factors for death in patients with nontyphoid Salmonella bacteremia were young age and an advanced stage of liver cirrhosis.
  
  
  CONCLUSIONS
  Most nontyphoid Salmonella bacteremia in patients with liver cirrhosis was community-acquired. An advanced stage of liver cirrhosis and hepatocellular carcinoma were common. The prognosis for young patients was unfavorable; this was seemingly due to hepatocellular carcinoma producing more unfavorable results in younger cirrhotic patients.
authors.affiliation: Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, ROC.
authors.forename: Ron-Bin
authors.initials: RB
authors.lastname: Hsu
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Chen
authors.forename: Shu-Hsun
authors.initials: SH
authors.lastname: Chu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000150:complications* / Q000175:diagnosis; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality; D017714:Community-Acquired Infections / Q000150:complications; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012480:Salmonella Infections / Q000150:complications* / Q000175:diagnosis; D013624:Taiwan