Invasive non-typhoidal Salmonella in adult patients: A three-year review in a Malaysian General Hospital
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Published:2023-03-01
Issue:
Volume:
Page:81-88
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ISSN:2672-7277
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Container-title:Asia Pacific Journal of Molecular Biology and Biotechnology
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language:en
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Short-container-title:APJMBB
Author:
Pirathaba Karshini Jeya1, Abdul Kahar Maria Kahar Bador1, Che Hussin Nurzam Suhaila2
Affiliation:
1. Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Jalan Professor Diraja Ungku Aziz, 59100 Kuala Lumpur, Malaysia 2. Microbiology Unit, Pathology Department, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
Abstract
Invasive non-typhoidal Salmonella (iNTS) are recognized as an important cause of infection among immunocompromised patients with high morbidity and mortality. This study focused on the epidemiology, risk factors, antibiotic susceptibility, and clinical outcome of iNTS in Hospital Kuala Lumpur over 3 years period (2017-2019). Methods: A retrospective study was conducted on 43 adult patient who had NTS isolated from a sterile sample. The patient’s microbiology worksheets and medical notes were reviewed and analyzed. Results: The overall incidence rate for iNTS was 2.4 per 10,000 admissions. The patients median age was 57 years, with majority of them being above ≥ 55 years old (n=24, 55.8%). The most prevalent diseases are hypertension (28%), human immunodeficiency virus (20.9%), diabetes mellitus (18.6%) and heart disease (6.3%). Primary bacteraemia (95.3%) was the most frequent cause of iNTS, followed by tubo-ovarian abscess (2.3%) and urinary tract infections (2.3%). The overall mortality rate was 30%. The mortality rate was greater in patient presenting with shock on admission (p=0.04). Most of the invasive diseases were caused by Salmonella enterica serovar Enteritidis (95.3%). Overall, most isolates were susceptible to ceftriaxone (97.7%). Five isolates were intermediately resistant to ciprofloxacin (11.6%). Only one isolate (2.3%) was multidrug resistant. Conclusions: The comorbidities of iNTS varies even within the same country. Mortality rates are higher in those with primary bacteraemia and shock during admission. By understanding the epidemiology of iNTS in Malaysia, it will provide valuable information about the vulnerable population at risk of iNTS and improve the treatment and management of this patients.
Publisher
Malaysian Society for Molecular Biology and Biotechnology
Subject
Molecular Biology,Biotechnology
Reference35 articles.
1. Aw, D., Silva, A. B., & Palmer, D. B. 2007. Immunosenescence: Emerging challenges for an ageing population. Immunology 120(4): 435–446. 2. Abridged Life Tables, Malaysia, 2019-2021 (2021). Department of Statistics Malaysia Official Portal. Dato' Sri Dr. Mohd Uzir Mahidin. Available at: https://www.dosm.gov.my/v1/ index.php (Accessed: January 25, 2023). 3. Ao, T. T., Feasey, N. A., Gordon, M. A., Keddy, K. H., Angulo, F. J., & Crump, J. A. 2015. Global burden of invasive nontyphoidal Salmonella disease, 2010. Emerging Infectious Diseases 21(6): 941–949. 4. Balasubramanian, R., Im, J., Lee, J. S., Jeon, H.J., Mogeni, O. D., Kim, J. H., Rakotozandrindrainy, R., Baker, S., & Marks, F. 2019. The global burden and epidemiology of invasive non-typhoidal Salmonella infections. Human Vaccines & Immunotherapeutics 15(6): 1421–1426. 5. CLSI, Performance Standards for Antimicrobial Susceptibility Testing. 29h ed. CLSI Supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute, 2019.
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