Nontyphoid Salmonella Infection in Heart Transplant Recipients

Background: There are only a few reported series of nontyphoid Salmonella infection in renal transplant recipients. Data are scarce in heart transplant recipients. This article described our experience with nontyphoid Salmonella infection in heart transplant recipients and reviewed the literature. Methods: Retrospective chart review. Data were compared with previously reported series in renal transplant recipients. Results: Of the 265 patients undergoing heart transplantation from 1987 to 2005, 4 patients (1.5%) had infection caused by nontyphoid Salmonella. All patients were male, aged ranging from 2 to 62 years. None of them had a history of acute rejection before the occurrence of Salmonella infection. The time interval between transplantation and the Salmonella infection ranged from 0 day to 17 months. Gastrointestinal salmonellosis occurred in 1 patient and bloodstream infection in 3 patients. Intravenous ceftriaxone was given in 3 bacteremic patients. One patient died after 6 days of septic shock. For nontyphoid Salmonella serogroups, 2 cases were group D and 2 cases were group C. Ciprofloxacin resistance was present in 1 of 4 Salmonella isolates. There was no recurrence in 3 survivors. Compared with previous reported cases in renal transplantation, patients with heart transplantation had low rates of urinary tract infection and recurrence. The mortality rate was 25% in heart transplant recipients. Conclusions: Nontyphoid Salmonella infection in heart transplant recipients occurred in the early posttransplant period. A significant number of patients had bloodstream infection. Although the mortality rate was high, there was no recurrence in survivors.