422: NEONATAL SALMONELLA INFECTIONS IN THE UNITED STATES FROM 1997 TO 2019

Introduction: Patients less than 3 months of age are at a higher risk of severe disease with salmonella infections. Neonatal salmonella infection, although rare, has been associated with poor outcomes, especially when presenting as meningitis or bacteremia. The objective of our study was to describe the demographic characteristics and trends in the prevalence of neonatal salmonella infections. Methods: A retrospective analysis of the Healthcare Cost (HCUP) and Utilization Project’s Kids’ Inpatient Database from 1997 to 2019 was performed. ICD 9 and 10 codes were used to identify salmonella infections in neonates (< 29 days of age). The linear trend for the prevalence of salmonella infection in neonates was performed using the Extended Mantel-Haenszel test (StatCalc, CDC). Results: Among a total of 27,941,351 neonatal discharges in the U.S, 706 neonates had salmonella infections (prevalence 25/1 million neonates). There was a decreasing trend in the prevalence of neonatal salmonella infections from 45 per million discharges in 1997 to 15 per million discharges in 2019 (p < 0.001). Neonates with salmonella infection were predominantly term gestation (95.0%, 95%CI: 92.7-96.6), White (57.9%, 95%CI: 52.4-63.2), and from the southern U.S. (50.5%, 95%CI: 45.1-56.0%). Most were admitted at urban teaching hospitals (87.2%, 95%CI: 78.3-92.7) and had government insurance (56.0%, 95%CI: 50.9-60.9). Salmonella enteritis was the most common discharge diagnosis (67.3%, 95%CI: CI 62.6-71.9), followed by sepsis (20.5%, 95%CI: 16.4-25.3), other salmonella infection (12.5%, 95%CI: 9.7-15.9) and meningitis (7.7%, 95%CI: 5.6-10.6). Invasive mechanical ventilation was provided for 5.7% (95%CI:3.8-8.4) of the neonates with salmonella infection and 5.5% (95%CI: 3.7-8.0) had underlying congenital heart disease. The mortality associated with neonatal salmonella was low (per HCUP guidelines any value < 11 cannot be reported). Conclusions: Salmonella infection is a rare diagnosis in neonates, and it is associated with low hospital mortality. The prevalence of salmonella infection in neonates has decreased from 1997 to 2019. Enteritis is the most common presentation of salmonella infection in neonates, and it should be considered in the differential diagnosis of neonates presenting with enteritis.