Nosocomial nontyphoidal salmonellosis after antineoplastic chemotherapy: reactivation of asymptomatic colonization?

Détails

ID Serval
serval:BIB_F790400E5B03
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Nosocomial nontyphoidal salmonellosis after antineoplastic chemotherapy: reactivation of asymptomatic colonization?
Périodique
European Journal of Clinical Microbiology & Infectious Diseases
Auteur(s)
Delaloye J., Merlani G., Petignat C., Wenger A., Zaman K., Monnerat C., Matzinger O., Beck Popovic M., Vuichard P., Ketterer N., Tarr P.E.
ISSN
0934-9723
Statut éditorial
Publié
Date de publication
2004
Peer-reviewed
Oui
Volume
23
Numéro
10
Pages
751-758
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Résumé
An increased frequency of nontyphoidal salmonellosis is well established in cancer patients, but it is unclear whether this represents increased susceptibility to exogenous infection or opportunistic, endogenous reactivation of asymptomatic carriage. In a retrospective study, a simple case definition was used to identify the probable presence of reactivation salmonellosis in five cancer patients between 1996 and 2002. Reactivation salmonellosis was defined as the development of nosocomial diarrhea >72 h after admission and following the administration of antineoplastic chemotherapy in an HIV-seronegative cancer patient who was asymptomatic on admission, in the absence of epidemiological evidence of a nosocomial outbreak. Primary salmonellosis associated with unrecognized nosocomial transmission or community acquisition and an unusually prolonged incubation period could not entirely be ruled out. During the same time period, another opportunistic infection, Pneumocystis pneumonia, was diagnosed in six cancer patients. Presumably, asymptomatic intestinal Salmonella colonization was converted to invasive infection by chemotherapy-associated intestinal mucosal damage and altered innate immune mechanisms. According to published guidelines, stool specimens from patients hospitalized for longer than 72 h should be rejected unless the patient is neutropenic or >or=65 years old with significant comorbidity. However, in this study neutropenia was present in only one patient, and four patients were <65 years old. Guidelines should thus be revised in order not to reject stool culture specimens from such patients. In cancer patients, nosocomial salmonellosis can occur as a chemotherapy-triggered opportunistic reactivation infection that may be similar in frequency to Pneumocystis pneumonia.
Mots-clé
Adult, Aged, Antineoplastic Agents, Carrier State, Cross Infection, Disease Susceptibility, Female, Humans, Infant, Male, Middle Aged, Neoplasms, Opportunistic Infections, Retrospective Studies, Salmonella, Salmonella Infections
Pubmed
Web of science
Création de la notice
20/01/2008 17:55
Dernière modification de la notice
03/03/2018 22:50
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