Epidemiology of nontyphoidal Salmonella bacteremia during the human immunodeficiency virus epidemic

Abstract

To assess the impact of the human immunodeficiency virus epidemic on nontyphoidal Salmonella septicemia and to identify risk factors for this infection, national laboratory-based Salmonella surveillance data and AIDS case reports were analyzed. Among 25- to 49-year-old men in states with a high incidence of AIDS, the proportion of Salmonella isolates reported from blood increased from 2.8% in 1978-1982 to 14.2% in 1983-1987, with substantial increases for serotypes enteritidis and typhimurium. Of adolescents and adults reported with AIDS from September 1987 through March 1990, 337 (0.48%) had recurrent Salmonella septicemia, with higher proportions among those who resided in the Northeast (0.86%), had a history of intravenous drug use (0.79%), or were black (0.74%) or Hispanic (0.57%). These data suggest that the risk of Salmonella septicemia in persons with AIDS is affected by geographic prevalence of Salmonella species, host characteristics, and invasiveness of infecting strains.