Risk factors for mortality caused by nontyphoidal Salmonella sp. in children

Int J Infect Dis. 2002 Sep;6(3):187-90. doi: 10.1016/s1201-9712(02)90109-8.


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.

MeSH terms

  • Adolescent
  • Bacteremia / microbiology
  • Bacteremia / mortality
  • Child
  • Child, Preschool
  • Diarrhea / complications
  • Female
  • Humans
  • Infant
  • Leukopenia / complications
  • Logistic Models
  • Male
  • Nutrition Disorders / complications
  • Risk Factors
  • Salmonella / classification
  • Salmonella / isolation & purification*
  • Salmonella Infections / microbiology
  • Salmonella Infections / mortality*
  • Salmonella Infections / physiopathology