Nontyphoidal Salmonella as a Rare Cause of UTI: A Case Report, Systematic Review, and Analysis of Surveillance Data.

Introduction and hypothesis: Urinary tract infections (UTIs) associated with nontyphoidal Salmonella (NTS; NTS-UTI) are uncommon. Although NTS infections typically result in gastroenteritis, cases of isolated UTIs have been documented. This report examines over 300 NTS-UTI cases described since 1980, highlighting trends in patient demographics, clinical presentation, and environmental exposure.

Methods: A search of the PubMed database was conducted for NTS-UTI reports published between 1980 and 2025. Urine isolate data reported by the Centers for Disease Control and Prevention (CDC) across the USA between 2020 and 2024 were analyzed to estimate the incidence of Salmonella Bareilly (S. Bareilly) UTI. Correlation between S. Bareilly incidence and both chicken and egg production was assessed to explore potential associations.

Results: A total of 321 patients with NTS-UTI were identified in our systematic review. The cohort had an average age of 54.5 ± 24.0 years and an approximate male-to-female ratio of 8:10. Contributing factors for NTS-UTI included comorbidities, such as diabetes and hypertension, and underlying urological conditions, including urolithiasis and recurrent UTI. Analysis of CDC surveillance data revealed a higher incidence of S. Bareilly UTI in the Four-State Area (Arkansas, Kansas, Missouri, Oklahoma) compared with the national average.

Conclusions: Our findings highlight the importance of considering nontyphoidal Salmonella (NTS) in the differential diagnosis of UTI. Environmental exposure, comorbid conditions, and genitourinary abnormalities appear to play a role in the pathogenesis of NTS-UTI. A better understanding of these contributing factors may help to identify at-risk populations in regions where enhanced surveillance may be warranted.