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Clinical and microbiological characterization of Salmonella spp. isolates from patients treated in a university hospital in South America between 2012–2021: a cohort study

BACKGROUND: Salmonellosis is a major cause of morbidity and mortality and one of the most frequent etiologies of diarrhea in the world. Mortality due to Salmonellosis in Latin America still poorly understood, and there is a lack of studies that evaluate resistance and clinical manifestations. The ai...

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Autores principales: Rosso, Fernando, Rebellón-Sánchez, David E., Llanos-Torres, Julio, Hurtado-Bermudez, Leidy Johanna, Ayerbe, Laura, Suárez, John Harold, Orozco-Echeverri, Nicolás, Rojas-Perdomo, Cristhian Camilo, Zapata-Vasquez, Isabel Lucia, Patiño-Niño, Jaime, Parra-Lara, Luis Gabriel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10519077/
https://www.ncbi.nlm.nih.gov/pubmed/37749501
http://dx.doi.org/10.1186/s12879-023-08589-y
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author Rosso, Fernando
Rebellón-Sánchez, David E.
Llanos-Torres, Julio
Hurtado-Bermudez, Leidy Johanna
Ayerbe, Laura
Suárez, John Harold
Orozco-Echeverri, Nicolás
Rojas-Perdomo, Cristhian Camilo
Zapata-Vasquez, Isabel Lucia
Patiño-Niño, Jaime
Parra-Lara, Luis Gabriel
author_facet Rosso, Fernando
Rebellón-Sánchez, David E.
Llanos-Torres, Julio
Hurtado-Bermudez, Leidy Johanna
Ayerbe, Laura
Suárez, John Harold
Orozco-Echeverri, Nicolás
Rojas-Perdomo, Cristhian Camilo
Zapata-Vasquez, Isabel Lucia
Patiño-Niño, Jaime
Parra-Lara, Luis Gabriel
author_sort Rosso, Fernando
collection PubMed
description BACKGROUND: Salmonellosis is a major cause of morbidity and mortality and one of the most frequent etiologies of diarrhea in the world. Mortality due to Salmonellosis in Latin America still poorly understood, and there is a lack of studies that evaluate resistance and clinical manifestations. The aims of this study were to characterize patients infected with Salmonella spp. seen in a university hospital in Colombia between 2012 and 2021, to evaluate trends in antibiotic resistance and to determine the proportion of overall mortality and related factors. METHODS: Retrospective observational study. All patients with microbiological diagnosis of Salmonella spp. were included. The sociodemographic, clinical and microbiological characteristics were described, and the proportion of antibiotic resistant isolates per year was estimated. The prevalence of mortality according to age groups was calculated. Log binomial regression models were used to establish factors associated with mortality. RESULTS: Five hundred twenty-two patients were analyzed. Salmonellosis accounted for 0.01% of all medical consultations. The median age was 16 years old. The most common clinical presentation was gastroenteric syndrome (77.1%) and symptoms included diarrhea (79.1%), fever (66.7%), abdominal pain (39.6%) and vomiting (35.2%). Of the Salmonella spp. isolates, 78.2% were not classified, 19.1% corresponded to non-typhoidal Salmonella and 2.7% to Salmonella typhi. Mortality occurs in 4.02% of the patients and was higher in patients with hematologic malignancy (11.6%). When analyzing by age group, the proportion of deaths was 2.8% in patients aged 15 years or younger, while in those older than 15 years it was 5.4%. Factors associated to mortality where bacteremia (aPR = 3.41 CI95%: 1.08—10.76) and to require treatment in the ICU (aPR = 8.13 CI95%: 1.82—37.76). In the last 10 years there has been a steady increase in resistance rates to ciprofloxacin, ampicillin, ampicillin/sulbactam and ceftriaxone, reaching rates above 60% in recent years. CONCLUSIONS: Despite improved availability of antibiotics for the treatment of salmonellosis in the past decades, mortality due to salmonellosis continues occurring in children and adults, mainly in patients with hematological malignancies and bacteremia. Antibiotic resistance rates have increased significantly over the last 10 years. Public health strategies for the control of this disease should be strengthened, especially in vulnerable populations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-023-08589-y.
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spelling pubmed-105190772023-09-26 Clinical and microbiological characterization of Salmonella spp. isolates from patients treated in a university hospital in South America between 2012–2021: a cohort study Rosso, Fernando Rebellón-Sánchez, David E. Llanos-Torres, Julio Hurtado-Bermudez, Leidy Johanna Ayerbe, Laura Suárez, John Harold Orozco-Echeverri, Nicolás Rojas-Perdomo, Cristhian Camilo Zapata-Vasquez, Isabel Lucia Patiño-Niño, Jaime Parra-Lara, Luis Gabriel BMC Infect Dis Research BACKGROUND: Salmonellosis is a major cause of morbidity and mortality and one of the most frequent etiologies of diarrhea in the world. Mortality due to Salmonellosis in Latin America still poorly understood, and there is a lack of studies that evaluate resistance and clinical manifestations. The aims of this study were to characterize patients infected with Salmonella spp. seen in a university hospital in Colombia between 2012 and 2021, to evaluate trends in antibiotic resistance and to determine the proportion of overall mortality and related factors. METHODS: Retrospective observational study. All patients with microbiological diagnosis of Salmonella spp. were included. The sociodemographic, clinical and microbiological characteristics were described, and the proportion of antibiotic resistant isolates per year was estimated. The prevalence of mortality according to age groups was calculated. Log binomial regression models were used to establish factors associated with mortality. RESULTS: Five hundred twenty-two patients were analyzed. Salmonellosis accounted for 0.01% of all medical consultations. The median age was 16 years old. The most common clinical presentation was gastroenteric syndrome (77.1%) and symptoms included diarrhea (79.1%), fever (66.7%), abdominal pain (39.6%) and vomiting (35.2%). Of the Salmonella spp. isolates, 78.2% were not classified, 19.1% corresponded to non-typhoidal Salmonella and 2.7% to Salmonella typhi. Mortality occurs in 4.02% of the patients and was higher in patients with hematologic malignancy (11.6%). When analyzing by age group, the proportion of deaths was 2.8% in patients aged 15 years or younger, while in those older than 15 years it was 5.4%. Factors associated to mortality where bacteremia (aPR = 3.41 CI95%: 1.08—10.76) and to require treatment in the ICU (aPR = 8.13 CI95%: 1.82—37.76). In the last 10 years there has been a steady increase in resistance rates to ciprofloxacin, ampicillin, ampicillin/sulbactam and ceftriaxone, reaching rates above 60% in recent years. CONCLUSIONS: Despite improved availability of antibiotics for the treatment of salmonellosis in the past decades, mortality due to salmonellosis continues occurring in children and adults, mainly in patients with hematological malignancies and bacteremia. Antibiotic resistance rates have increased significantly over the last 10 years. Public health strategies for the control of this disease should be strengthened, especially in vulnerable populations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-023-08589-y. BioMed Central 2023-09-25 /pmc/articles/PMC10519077/ /pubmed/37749501 http://dx.doi.org/10.1186/s12879-023-08589-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Rosso, Fernando
Rebellón-Sánchez, David E.
Llanos-Torres, Julio
Hurtado-Bermudez, Leidy Johanna
Ayerbe, Laura
Suárez, John Harold
Orozco-Echeverri, Nicolás
Rojas-Perdomo, Cristhian Camilo
Zapata-Vasquez, Isabel Lucia
Patiño-Niño, Jaime
Parra-Lara, Luis Gabriel
Clinical and microbiological characterization of Salmonella spp. isolates from patients treated in a university hospital in South America between 2012–2021: a cohort study
title Clinical and microbiological characterization of Salmonella spp. isolates from patients treated in a university hospital in South America between 2012–2021: a cohort study
title_full Clinical and microbiological characterization of Salmonella spp. isolates from patients treated in a university hospital in South America between 2012–2021: a cohort study
title_fullStr Clinical and microbiological characterization of Salmonella spp. isolates from patients treated in a university hospital in South America between 2012–2021: a cohort study
title_full_unstemmed Clinical and microbiological characterization of Salmonella spp. isolates from patients treated in a university hospital in South America between 2012–2021: a cohort study
title_short Clinical and microbiological characterization of Salmonella spp. isolates from patients treated in a university hospital in South America between 2012–2021: a cohort study
title_sort clinical and microbiological characterization of salmonella spp. isolates from patients treated in a university hospital in south america between 2012–2021: a cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10519077/
https://www.ncbi.nlm.nih.gov/pubmed/37749501
http://dx.doi.org/10.1186/s12879-023-08589-y
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