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Background  In sub-Saharan Africa, non-typhoidal  Salmonella  (NTS) can cause bloodstream infections, referred to as invasive non-typhoidal  Salmonella  disease (iNTS disease); it can occur in outbreaks and is often preceded by malaria. Data from Central Africa is limited.    Methods  Clinical, microbiological and molecular findings of NTS recovered in a blood culture surveillance project (2009–2014) were analyzed.    Results  In March-July 2012 there was an epidemic increase in malaria infections in the Oriental Province of the Democratic Republic of the Congo (DRC). In one referral hospital, overall hospital admissions in June 2012 were 2.6 times higher as compared to the same period in the years before and after (336 versus an average of 128 respectively); numbers of malaria cases and blood transfusions were nearly three- and five-fold higher respectively (317 versus 112 and 250 versus 55). Case fatality rates (in-hospital deaths versus all admissions) peaked at 14.6 %.  Salmonella  Typhimurium and  Salmonella  Enteritidis together accounted for 88.9 % of pathogens isolated from blood cultures collected during an outreach visit to the affected districts in June 2012. Children infected with  Salmonella  Enteritidis (33 patient files available) tended to be co-infected with  Plasmodium falciparum  more often than children infected with  Salmonella  Typhimurium (40 patients files available) (81.8 % versus 62.5 %). Through the microbiological surveillance project (May 2009–May 2014) 113 unique NTS isolates were collected (28.5 % (113/396) of pathogens); most (95.3 %) were recovered from children < 15 years.  Salmonella  Typhimurium ( n  = 54) and  Salmonella  Enteritidis ( n  = 56) accounted for 47.8 % and of 49.6 % NTS isolates respectively. Multilocus variable-number tandem-repeat analysis (MLVA) revealed more heterogeneity for  Salmonella  Typhimurium than for  Salmonella  Enteritidis. Most (82/96, 85.4 %) NTS isolates that were available for antibiotic susceptibility testing were multidrug resistant. All isolates were susceptible to ceftriaxone and azithromycin.    Conclusion  During the peak of an epidemic increase in malaria in the DRC in 2012, a high proportion of multidrug resistant  Salmonella  Typhimurium and  Salmonella  Enteritidis were isolated from blood cultures. Overall, the two serovars showed subtle differences in clinical presentation and genetic diversity.    Electronic supplementary material  The online version of this article (doi:10.1186/s12879-016-1604-1) contains supplementary material, which is available to authorized users.

bmc infectious diseases

Microbiological, clinical and molecular findings of non-typhoidal Salmonella bloodstream infections associated with malaria, Oriental Province, Democratic Republic of the Congo