Risk factors for development of nontyphoid Salmonella bacteremia.

The objective of this paper was to identify risk factors for nontyphoid Salmonella bacteremia by making a retrospective chart review of 39 patients with nontyphoid Salmonella bacteremia. The control group included 30 patients with positive Salmonella stool culture (gastroenteritis group). Demographic factors, presenting signs and symptoms, antimicrobial treatment before admission, and microbiologic results were recorded. Nine patients (23%) were excluded owing to recognized risk factors for development of extraintestinal disease. Seventeen cases (57%) occurred during summer time, whereas the gastroenteritis group had a less seasonal tendency. Eighty percent of the patients with Salmonella bacteremia had a previous history of diarrhea. At admission more patients in the bacteremia group were febrile and had leukocytosis (73% vs 33% and 37% vs 20%, respectively). More patients in the bacteremia group had previous antibiotic treatment (57% vs 20%, p<0.01). The Salmonella types were mainly C and D in the bacteremia group (40% each), and B and C in the gastroenteritis group (26% and 52%, respectively). The risk factors for Salmonella bacteremia in previously healthy children include warm season, previous gastrointestinal illness, and preexposure to antibiotics.