Infekce způsobené netyfovými sérovary salmonel na Klinice infekčních chorob Fakultní nemocnice Brno v letech 2011-2013 - retrospektivní studie

Title in English Infections caused by non-Typhi serovars of Salmonella at the Infectious Diseases Clinic of the University Hospital Brno in 2011-2013
Authors

POLÁK Pavel VRBA Martin BORTLÍČEK Zbyněk JURÁNKOVÁ Jana FREIGERGEROVÁ Michaela HUSA Petr KAMELANDER Jan DASTYCH Milan

Year of publication 2014
Type Article in Periodical
Magazine / Source Epidemiologie, mikrobiologie, imunologie
MU Faculty or unit

Faculty of Medicine

Citation
Field Epidemiology, infectious diseases and clinical immunology
Keywords almonellosis; antibiotic resistance; sepsis; carriage
Description Materials and methods: A retrospective analysis of clinical and laboratory parameters of 161 patients hospitalized at the Infectious Diseases Clinic of the University Hospital Brno from 1 January 2011 to 31 December 2013. Results: Invasive salmonellosis was seen in 22.4 % of the study group. The overall lethality rate reached 3.1 %. Treatment with antibiotics was used in 93.8% of patients. Transient mild to moderate leukocytopenia was reported in 4.3 % of patients and thrombocytopenia in 9.3% of patients. Transient changes in white blood cells as well as in the thrombocyte count were not clinically important. Long-term treatment with proton pump inhibitors is a risk factor for salmonellosis (p = 0.128), but not for invasive salmonellosis. Long-term use of opioids (p = 0.003) and/or acetylsalicylic acid (p = 0.015) is a risk factor for invasive salmonellosis. Other risk factors for invasive disease are: age over 70 years (p = 0.011), arterial hypertension (p = 0.004), disease duration of less than three days (p = 0.006), serum creatinine level above 250 u.mol/1 (p = 0.01), peripheral leucocyte count above 12 x 10''/l (p=0.001). and body temperature above 38 "C (p = 0.001). Hypokalemia does not represent a risk factor for invasive salmonellosis. Conclusions: Aged patients on long-term opioids or acetyl-salicylic acid, with disease duration of less than three days, and meeting the criteria for systemic inflammatory response syndrome are at the highest risk for invasive salmonellosis. Empirical antibiotics are prescribed too often and the treatment is not properly de-escalated.

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