Risk factors for recurrent bacteremia in adult patients with nontyphoid salmonellosis

Background. This study sought to find the risk factors for recurrent bacteremia in adult patients with nontyphoid salmonellosis. Method: Retrospective chart review. Result: Between September 1984 and December 2003, 235 adult (age greater than or equal to 18 years old) patients with bacteremia with nontyphoid salmonellosis were admitted to our hospital. Among them, 130 patients (55%) had immunodeficiency, 31 patients (13%) had systemic lupus erythematosus, 26 patients (11%) had hematologic malignancies, 50 patients (21%) had solid organ cancers, and 3 9 patients (17%) had endovascular infections. Thirty-seven patients had recurrent bacteremia during the study period. Both univariate and multivariate analysis showed that immunodeficiency was the only predictor of recurrent bacteremia (odds ratio, 2.79; P = 0.013). The overall hospital mortality rate was 26%: 8% for patients with recurrent bacteremia and 29% for patients without recurrence. The independent risk factors of hospital death were old age, not recurrent infection, and solid organ cancers. Conclusion: Old age, systemic lupus erythematosus, malignancies, and immunodeficiency were common in adult patients with nontyphoid Salmonella bacteremia. The incidence of recurrent bacteremia was 16%. Immunodeficiency predisposed patients to recurrent bacteremia. Recurrent bacteremia was associated with a lower hospital mortality rate, however.