Severity of non-typhoid salmonellosis as a predictor of 030 and 31365 day mortality
Abstract number: P1641
Gradel K.O., Ejlertsen T., Schønheyder H.C., Nielsen H.
Objectives: To evaluate whether hospitalisation, ordering of blood cultures, or detection of bacteraemia were predictors of mortality in patients with non-typhoid salmonellosis (NTS).
Methods: Population-based registry study comprising all patients with a first-time NTS detected in stool cultures, in North Jutland County (Denmark) from 1995 through 2003. Patients were categorised into four groups: group 1) not hospitalised; group 2) hospitalised 30 days within their NTS without blood cultures (BC) being ordered; group 3) hospitalised with negative BC only; group 4) hospitalised with bacteraemia. We obtained data in the county's hospital discharge registry on comorbidity as recorded from 1977 and hospitalisation. Complete follow-up was possible through the Danish civil registration system. Age and comorbidity adjusted Cox's regression analyses were used to compute mortality rate ratios (MRR) with 95% confidence intervals (CI) at 030 and 31365 days.
Results: Among 1,764 NTS patients, 1,082 (61.3%) were not hospitalised, 344 (19.5%) were hospitalised without BC being ordered, 245 (13.9%) were hospitalised with negative BC, and 93 (5.3%) had bacteraemia (Salmonella in 81, other pathogens in 12). Within one year, 2 (0.2%) died in group 1, 14 (4.1%) in group 2, 20 (8.2%) in group 3, and 19 (20.4%) in group 4. Using group 2 as reference, 030 day adjusted MRR (95% CI) could not be calculated in group 1 (no deaths), whereas they were 1.8 (0.65.7) and 1.3 (0.44.6) in groups 3 and 4, respectively. For 31365 days, adjusted MRR (95% CI) were 0.16 (0.030.78) in group 1, 1.6 (0.693.9) in group 3, and 2.3 (1.05.5) in group 4.
Conclusion: The general practitioner's decision to hospitalize NTS patients was a predictor of short-term and long-term mortality independent of age and comorbidity. When hospitalised, the physician's decision to obtain blood cultures or the detection of bacteraemia were independent predictors of mortality, albeit the statistical precision was low.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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