Tena Daniel, González-Praetorius Alejandro, Bisquert Julia
Section of Microbiology, University Hospital of Guadalajara, C/. Donantes de sangre s/n, 19002 Guadalajara, Spain.
J Infect. 2007 Mar;54(3):245-9. doi: 10.1016/j.jinf.2006.05.007. Epub 2006 Jul 7.
Urinary tract infection (UTI) caused by non-typhoidal Salmonella (NTS) is rare. The aims were to know the frequency and clinical characteristics of this infection in our area.
We performed a retrospective analysis of patients with bacteriuria due to NTS diagnosed in our hospital from January 1990 to December 2005.
Nineteen patients with bacteriuria caused by NTS were diagnosed, representing 0.07% of the UTIs diagnosed in our area over the same period. The mean age was 62.5 years old. Eighteen patients (94.7%) had symptoms of UTI (12, cystitis; 6, pyelonephritis), and 1 remained asymptomatic. Fourteen patients (73.6%) had chronic diseases; diabetes mellitus was present in 8 of them (42.1%) and 7 patients (36.8%) were undergoing immunosuppressor treatment. Eight patients (42.1%) had urologic abnormalities. S. enteritidis was the most common serotype isolated (16 cases). Eleven patients required antibiotic treatment over 2 or more weeks. Four patients had recurrent Salmonella UTIs (22.2%), and in 2 of them recurrence occurred after prolonged treatment during 3.5 and 5 weeks, respectively.
UTI due to NTS was predominantly observed in elderly patients with underlying diseases, especially diabetes mellitus, urologic abnormalities and immunosuppression. Prolonged antibiotic treatment should be considered due to the high frequency of complicating conditions, although the infection can be recurrent despite prolonged treatment.
非伤寒沙门菌(NTS)引起的尿路感染(UTI)较为罕见。本研究旨在了解该感染在我们地区的发生率及临床特征。
我们对1990年1月至2005年12月在我院诊断为NTS菌尿症的患者进行了回顾性分析。
共诊断出19例由NTS引起的菌尿症患者,占同期本地区诊断出的UTI患者的0.07%。平均年龄为62.5岁。18例患者(94.7%)有UTI症状(12例为膀胱炎;6例为肾盂肾炎),1例无症状。14例患者(73.6%)患有慢性疾病;其中8例(42.1%)患有糖尿病,7例(36.8%)正在接受免疫抑制剂治疗。8例患者(42.1%)有泌尿系统异常。肠炎沙门菌是最常见的分离血清型(16例)。11例患者需要接受超过2周或更长时间的抗生素治疗。4例患者(22.2%)出现复发性沙门菌UTI,其中2例分别在延长治疗3.5周和5周后复发。
NTS引起的UTI主要见于患有基础疾病的老年患者,尤其是糖尿病、泌尿系统异常和免疫抑制患者。由于并发症发生率高,应考虑延长抗生素治疗时间,尽管延长治疗后感染仍可能复发。