{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T23:19:37Z","timestamp":1793229577409,"version":"4.5.0"},"reference-count":21,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Non-Typhoidal Salmonellas (NTSs) are diffused worldwide. In Italy, more than 3500 cases are notified each year, but despite this, data about salmonellosis are scarce. Our multi-center, retrospective, descriptive study selected 252 patients with positive cultures for Salmonella spp. (feces 79.8%, blood 8.7%, feces and blood 7.5%), aiming to describe the epidemiological and clinical characteristics of this population. Bacteremic infections constituted 16.3% (41\/252) of patients. Extreme ages (\u226412 and \u226565 years old) accounted for 79.7%, but only elder ages were strongly associated with bacteremic infections (aOR 5.78). Invasive infections had a 7-fold higher mortality rate than non-invasive disease (9.8% vs. 1.4%, p = 0.013), with an overall rate of 2.8%. The two more represented serogroups were O:4 (52.8%) and O:9 (22.2%). The O:9 serogroup was strongly associated with a higher frequency of invasive infection (aOR 2.96, 95% CI 1.17\u20137.63). In particular, S. napoli, an emerging serovar in Europe, accounted for 31.7% of bacteremic infections and only 9.5% of non-bacteremic ones (p &lt; 0.001). Antibiotic microbial resistance (AMR) observed a steep increasing trend and was detected in 60.4% of cases (122\/202): amoxicillin\/clavulanate, ampicillin, and gentamicin were most commonly involved (26.7%, 21.8%, 14.3%, respectively), while TMP\/SMX, ciprofloxacin, and ceftriaxone were &lt;10%. Resistance was, in general, less common in the O:9 serogroup, while amikacin resistance was significantly more common. Factors associated with an MDR Salmonella acquisition were time (OR 1.37 per year more), O:4 serogroup (OR 2.67), and being a woman (OR 2.11). The most frequent symptoms were diarrhea (90.5%) and fever (81.7%). In conclusion, our study highlights a high burden of NTS infections, leading to severe or fatal outcomes in frail patients. Furthermore, AMR shows an increasing trend with a concerning high prevalence of cephalosporine resistance compared to the rest of Europe.<\/jats:p>","DOI":"10.3390\/pathogens12111298","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T12:07:45Z","timestamp":1698667665000},"page":"1298","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Invasive and Non-Invasive Human Salmonellosis Cases Admitted between 2015 and 2021 in Four Suburban Hospitals in the Metropolitan Area of Milan (Italy): A Multi-Center Retrospective Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1668-7543","authenticated-orcid":false,"given":"Gabriele","family":"Pagani","sequence":"first","affiliation":[{"name":"UOC Malattie Infettive, ASST Ovest-Milanese, Ospedale Nuovo di Legnano, Via Papa Giovanni II s.n., Legnano, 20025 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Parenti","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche e Cliniche \u201cL. Sacco\u201d, Universit\u00e0 Statale degli Studi di Milano, Via G.B., Grassi 74, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6203-7584","authenticated-orcid":false,"given":"Marco","family":"Franzetti","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive, ASST Ovest-Milanese, Ospedale Nuovo di Legnano, Via Papa Giovanni II s.n., Legnano, 20025 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Pezzati","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive, ASST Ovest-Milanese, Ospedale Nuovo di Legnano, Via Papa Giovanni II s.n., Legnano, 20025 Milano, Italy"},{"name":"Dipartimento di Scienze Biomediche e Cliniche \u201cL. Sacco\u201d, Universit\u00e0 Statale degli Studi di Milano, Via G.B., Grassi 74, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7002-7044","authenticated-orcid":false,"given":"Francesco","family":"Bassani","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive, ASST Ovest-Milanese, Ospedale Nuovo di Legnano, Via Papa Giovanni II s.n., Legnano, 20025 Milano, Italy"},{"name":"Dipartimento di Scienze Biomediche e Cliniche \u201cL. Sacco\u201d, Universit\u00e0 Statale degli Studi di Milano, Via G.B., Grassi 74, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca","family":"Osnaghi","sequence":"additional","affiliation":[{"name":"UOC Microbiologia, ASST Ovest-Milanese, Ospedale Nuovo di Legnano, Via Papa Giovann II s.n., 20025 Legnano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Vismara","sequence":"additional","affiliation":[{"name":"UOC Microbiologia, ASST Ovest-Milanese, Ospedale Nuovo di Legnano, Via Papa Giovann II s.n., 20025 Legnano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Pavia","sequence":"additional","affiliation":[{"name":"UOC Microbiologia, ASST Ovest-Milanese, Ospedale Nuovo di Legnano, Via Papa Giovann II s.n., 20025 Legnano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Mirri","sequence":"additional","affiliation":[{"name":"UOC Microbiologia, ASST Ovest-Milanese, Ospedale Nuovo di Legnano, Via Papa Giovann II s.n., 20025 Legnano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0375-9990","authenticated-orcid":false,"given":"Stefano","family":"Rusconi","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive, ASST Ovest-Milanese, Ospedale Nuovo di Legnano, Via Papa Giovanni II s.n., Legnano, 20025 Milano, Italy"},{"name":"Dipartimento di Scienze Biomediche e Cliniche \u201cL. 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