Risk Factors for Nontyphi Salmonella Bacteremia Over 10 Years in Fort-de-France, Martinique, West Indies

Arnaud Buteux Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France;

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Mathieu Nacher EA 3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, France;
INSERM CIC1424 Centre d’Investigation Clinique Antilles Guyane, Centre Hospitalier Andrée Rosemon, Cayenne, France;

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Célia Merat Service de Parasitologie et Mycologie, Centre Hospitalier Universitaire de Nantes, Nantes, France;

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Duc Nguyen EA 3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, France;
Service de Maladies Infectieuses et Tropicale, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France;

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Benoit Roze Service de Maladies Infectieuses et Tropicale, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France;

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André Cabié Service de Maladies Infectieuses et Tropicale, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France;
INSERM CIC1424 Centre d’Investigation Clinique Antilles Guyane, Centre Hospitalier Andrée Rosemon, Cayenne, France;
EA 4537 Maladies Infectieuses et Tropicales dans la Caraïbe, Université des Antilles, Pointe-à-Pitre, France

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Claude Olive Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France;
EA 4537 Maladies Infectieuses et Tropicales dans la Caraïbe, Université des Antilles, Pointe-à-Pitre, France

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Nontyphoidal Salmonella infections can result in bacteremia. This study was undertaken to determine the predictive factors for bacteremia in children aged less than 16 years. Medical data were collected for every child with positive nontyphoidal Salmonella cultures in blood or stools at the University hospital of Martinique, French West Indies, between January 2005 and December 2015. Among 454 patients, 333 were included; 156 cases had confirmed bacteremia, and 177 were included as control group with nontyphoidal Salmonella only isolated in stools. Age at diagnosis, delay before consulting, prematurity, immunosuppression, or hyperthermic seizures were not significantly associated with bacteremia. C-reactive protein was higher in cases of bacteremia (P = 0.01); however, after adjusting to the threshold of 30 mg/L, there was no longer any difference. There were also significant relations for electrolytes such as hyponatremia (odds ratio (OR) = 2.08 [95% CI = 1.31–3.95]; P < 0.01), high urea level (OR = 0.53 [95% CI = 0.32–0.88], P < 0.01). The infecting serotype was the most discriminant risk factor (P < 10−4). Among 28 serotypes isolated between 2005 and 2015, Salmonella panama was the most common serotype: 122 strains (78.2%) were isolated from bacteremic patients versus 60 (33.9%) from nonbacteremic patients (P < 10−4). Salmonella panama was the most important risk factor for bacteremia (OR = 7.37 [95% CI = 3.18–17.1], P < 10−4) even after multivariate analysis (OR = 13.09 [95% CI = 5.42–31.59], P < 10−4). After adjusting for bacteremia, S. panama was associated with a significantly higher body temperature than other Salmonella: 39°C (standard deviation [SD] = 0.92) versus 38.2°C [SD = 1.1], linear regression P < 10−3. Children with Salmonella serotype panama infection were at higher risk of bacteremia than children infected with other Salmonella serotypes.

Author Notes

Address correspondence to Arnaud Buteux, Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France. E-mail: arnaudbuteux@gmail.com

Author’s addresses: Arnaud Buteux, Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France, E-mail: arnaudbuteux@gmail.com. Mathieu Nacher, EA 3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, France, and INSERM CIC1424 Centre d’Investigation Clinique Antilles Guyane, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France, E-mail: Mathieu.nacher66@gmail.com. Célia Merat, Service de Parasitologie et Mycologie, Centre Hospitalier Universitaire de Nantes, Nantes, France, E-mail: celia.merat@orange.fr. Duc Nguyen, EA 3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, France, and Service de Maladies Infectieuses et Tropicale, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France, E-mail: duc1520@yahoo.fr. Benoit Roze, Service de Maladies Infectieuses et Tropicale, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France, E-mail: benoit.roze@chu-fortdefrance.fr. André Cabié, Service de Maladies Infectieuses et Tropicale, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France, INSERM CIC1424 Centre d’Investigation Clinique Antilles Guyane, France, and EA 4537 Maladies Infectieuses et Tropicales dans la Caraïbe, Université des Antilles, France, E-mail: andre.cabie@chu-fortdefrance.fr. Claude Olive, Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France, and EA 4537 Maladies Infectieuses et Tropicales dans la Caraïbe, Université des Antilles, France, E-mail: claude.olive@chu-fortdefrance.fr.

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