Epidemiology and Infection



Bacteraemia due to ciprofloxacin-resistant Salmonella enterica serotype Choleraesuis in adult patients at a university hospital in Taiwan, 1996–2004


J.-Y. WANG a1, J.-J. HWANG a2c1, C.-N. HSU a2, L.-C. LIN a2 and P.-R. HSUEH a2a3c1
a1 Department of Internal Medicine, Cardinal Tien Hospital, Fu Jen Catholic University College of Medicine, Taipei, Taiwan
a2 Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
a3 Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

Article author query
wang jy   [PubMed][Google Scholar] 
hwang jj   [PubMed][Google Scholar] 
hsu cn   [PubMed][Google Scholar] 
lin lc   [PubMed][Google Scholar] 
hsueh pr   [PubMed][Google Scholar] 

Abstract

Eighty-one adult patients with Salmonella enterica serotype Choleraesuis (S. Choleraesuis) bacteraemia treated at a university hospital from 1996 to 2004 were evaluated. Multivariate analysis with a logistic regression model was used to characterize risk factors for primary bacteraemia and mycotic aneurysm and to determine the association of clinical characteristics of patients based on ciprofloxacin susceptibility of the causative organism. The incidence per 100000 discharges was 0·76 in 1996 and 3·9 in 2004. The overall rate of ciprofloxacin resistance among these isolates was 59% (87 isolates) and the annual rate increased with time from 0% prior to 2000 to 80% in 2004. Among these patients, 48 (59%) had primary bacteraemia and 13 (16%) had secondary bacteraemia with mycotic aneurysm. Seventy (86%) patients had fever at presentation, 22 (27%) developed shock during hospitalization, and eight (10%) died of S. Choleraesuis bacteraemia. Patients with immunocompromised conditions had a higher risk of developing primary bacteraemia (OR 18·442, P<0·001). Hypertension (OR 15·434, P=0·002) and male gender (OR 7·422, P=0·039) were associated with mycotic aneurysm. Patients with mycotic aneurysm were more frequently infected with ciprofloxacin-susceptible isolates (P=0·028) and ciprofloxacin-susceptible isolates were also more frequently associated with recurrent infection than ciprofloxacin-resistant isolates (P=0·038). The incidence of S. Choleraesuis bacteraemia has increased in the past 8 years, and this increase is associated with the upsurge of ciprofloxacin-resistant isolates.

(Accepted January 5 2006)
(Published Online March 29 2006)


Correspondence:
c1 Departments of Laboratory Medicine and Internal Medicine; Dr J.-J. Hwang, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicne, 7 Chung-Shan South Road, Taipei, Taiwan. (Email: hsporen@ha.mc.ntu.edu.tw)


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