Nontyphoid salmonella bacteremia: Age-related differences in clinical presentation, bacteriology, and outcome

In a retrospective study, 80 episodes of nontyphoid salmonella (NTS) bacter emia in children were compared with 55 episodes in adults over a 10-year pe riod, The study disclosed major differences in the predisposition, clinical presentation, and outcome as well as the microbiology of NTS bacteremia in relation to age. Adults were more likely than children to have predisposin g diseases(95% vs, 15% respectively; P < .0001) and to receive prior medica tions (95% vs. 23%, respectively; P < .0001), particularly immunosuppressiv e agents (58% vs. 5%, respectively; P < .0001). In most adults (67%), NTS i nfection presented as a primary bacteremia and was associated with a high i ncidence of extraintestinal organ involvement (34%) and a high mortality ra te (33%). In children, NTS bacteremia was usually secondary to gastroenteri tis (75%) and caused no fatalities. Although group B Salmonella (78%) and t he serovar Salmonella enteritidis were the predominant isolates from adults , the emergence of infections due to group C Salmonella ( 46%) and the sero var Salmonella virchow in children was noted.