Salmonella enterica serotype choleraesuis infections in pediatric patients

Cheng Hsun Chiu, Chih Hsien Chuang, Shun Chiu, Lin Hui Su, Tzou Yien Lin

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

OBJECTIVE. Among >2500 nontyphoid Salmonella serotypes, Salmonella enterica serotype Choleraesuis shows a high predilection to cause systemic infections in humans. The objective of this study was to delineate the clinical and microbiologic features of pediatric patients with Salmonella Choleraesuis infections. METHODS. Between May 1999 and February 2003, a total of 33 patients who were <18 years of age had culture-confirmed S Choleraesuis infections. Clinical features, laboratory values, treatment, outcome, and antimicrobial susceptibility patterns of the bacterial isolates were analyzed. RESULTS. There were 24 males and 9 females with a mean age of 3 years. Fever (rectal temperature ≥38° C; 94%) was the most common clinical presentation. Sixteen (52%) had fever lasting >5 days before admission. Only 18 (54%) patients had diarrhea. The most common mode of infection is occult bacteremia without focal infection. Compared with data obtained from adult patients, the gastrointestinal manifestations appeared more frequently seen in pediatric patients. However, among the 18 who presented with diarrhea, 14 had concomitant bloodstream infection. Only 1 patient, who was a case of acute leukemia, died of S Choleraesuis sepsis. Resistance to ceftriaxone, ciprofloxacin, ampicillin, trimethoprim-sulfamethoxazole, and chloramphenicol was found in 6%, 28%, 88%, 76%, and 83% of the isolates, respectively. CONCLUSION. Children with S Choleraesuis infections usually presented with occult bacteremia with mild gastrointestinal involvement. The mortality of S Choleraesuis infections in previously healthy children is low. Ciprofloxacin resistance among S Choleraesuis isolates from pediatric patients was lower than that of isolates from adult patients. In view of the high rate of multidrug resistance, third-generation cephalosporins seem to be the drug of choice for treatment of invasive S Choleraesuis infections.

Original languageEnglish
JournalPediatrics
Volume117
Issue number6
DOIs
Publication statusPublished - Jun 2006
Externally publishedYes

Fingerprint

Salmonella enterica
Pediatrics
Infection
Ciprofloxacin
Bacteremia
Diarrhea
Focal Infection
Ceftriaxone
Serogroup
Salmonella Infections
Sulfamethoxazole Drug Combination Trimethoprim
Multiple Drug Resistance
Chloramphenicol
Cephalosporins
Ampicillin
Salmonella
Sepsis
Leukemia
Mortality

Keywords

  • Antimicrobial resistance
  • Bacteremia
  • Salmonella enterica serotype Choleraesuis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Salmonella enterica serotype choleraesuis infections in pediatric patients. / Chiu, Cheng Hsun; Chuang, Chih Hsien; Chiu, Shun; Su, Lin Hui; Lin, Tzou Yien.

In: Pediatrics, Vol. 117, No. 6, 06.2006.

Research output: Contribution to journalArticle

Chiu, Cheng Hsun ; Chuang, Chih Hsien ; Chiu, Shun ; Su, Lin Hui ; Lin, Tzou Yien. / Salmonella enterica serotype choleraesuis infections in pediatric patients. In: Pediatrics. 2006 ; Vol. 117, No. 6.
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abstract = "OBJECTIVE. Among >2500 nontyphoid Salmonella serotypes, Salmonella enterica serotype Choleraesuis shows a high predilection to cause systemic infections in humans. The objective of this study was to delineate the clinical and microbiologic features of pediatric patients with Salmonella Choleraesuis infections. METHODS. Between May 1999 and February 2003, a total of 33 patients who were <18 years of age had culture-confirmed S Choleraesuis infections. Clinical features, laboratory values, treatment, outcome, and antimicrobial susceptibility patterns of the bacterial isolates were analyzed. RESULTS. There were 24 males and 9 females with a mean age of 3 years. Fever (rectal temperature ≥38° C; 94{\%}) was the most common clinical presentation. Sixteen (52{\%}) had fever lasting >5 days before admission. Only 18 (54{\%}) patients had diarrhea. The most common mode of infection is occult bacteremia without focal infection. Compared with data obtained from adult patients, the gastrointestinal manifestations appeared more frequently seen in pediatric patients. However, among the 18 who presented with diarrhea, 14 had concomitant bloodstream infection. Only 1 patient, who was a case of acute leukemia, died of S Choleraesuis sepsis. Resistance to ceftriaxone, ciprofloxacin, ampicillin, trimethoprim-sulfamethoxazole, and chloramphenicol was found in 6{\%}, 28{\%}, 88{\%}, 76{\%}, and 83{\%} of the isolates, respectively. CONCLUSION. Children with S Choleraesuis infections usually presented with occult bacteremia with mild gastrointestinal involvement. The mortality of S Choleraesuis infections in previously healthy children is low. Ciprofloxacin resistance among S Choleraesuis isolates from pediatric patients was lower than that of isolates from adult patients. In view of the high rate of multidrug resistance, third-generation cephalosporins seem to be the drug of choice for treatment of invasive S Choleraesuis infections.",
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AU - Su, Lin Hui

AU - Lin, Tzou Yien

PY - 2006/6

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N2 - OBJECTIVE. Among >2500 nontyphoid Salmonella serotypes, Salmonella enterica serotype Choleraesuis shows a high predilection to cause systemic infections in humans. The objective of this study was to delineate the clinical and microbiologic features of pediatric patients with Salmonella Choleraesuis infections. METHODS. Between May 1999 and February 2003, a total of 33 patients who were <18 years of age had culture-confirmed S Choleraesuis infections. Clinical features, laboratory values, treatment, outcome, and antimicrobial susceptibility patterns of the bacterial isolates were analyzed. RESULTS. There were 24 males and 9 females with a mean age of 3 years. Fever (rectal temperature ≥38° C; 94%) was the most common clinical presentation. Sixteen (52%) had fever lasting >5 days before admission. Only 18 (54%) patients had diarrhea. The most common mode of infection is occult bacteremia without focal infection. Compared with data obtained from adult patients, the gastrointestinal manifestations appeared more frequently seen in pediatric patients. However, among the 18 who presented with diarrhea, 14 had concomitant bloodstream infection. Only 1 patient, who was a case of acute leukemia, died of S Choleraesuis sepsis. Resistance to ceftriaxone, ciprofloxacin, ampicillin, trimethoprim-sulfamethoxazole, and chloramphenicol was found in 6%, 28%, 88%, 76%, and 83% of the isolates, respectively. CONCLUSION. Children with S Choleraesuis infections usually presented with occult bacteremia with mild gastrointestinal involvement. The mortality of S Choleraesuis infections in previously healthy children is low. Ciprofloxacin resistance among S Choleraesuis isolates from pediatric patients was lower than that of isolates from adult patients. In view of the high rate of multidrug resistance, third-generation cephalosporins seem to be the drug of choice for treatment of invasive S Choleraesuis infections.

AB - OBJECTIVE. Among >2500 nontyphoid Salmonella serotypes, Salmonella enterica serotype Choleraesuis shows a high predilection to cause systemic infections in humans. The objective of this study was to delineate the clinical and microbiologic features of pediatric patients with Salmonella Choleraesuis infections. METHODS. Between May 1999 and February 2003, a total of 33 patients who were <18 years of age had culture-confirmed S Choleraesuis infections. Clinical features, laboratory values, treatment, outcome, and antimicrobial susceptibility patterns of the bacterial isolates were analyzed. RESULTS. There were 24 males and 9 females with a mean age of 3 years. Fever (rectal temperature ≥38° C; 94%) was the most common clinical presentation. Sixteen (52%) had fever lasting >5 days before admission. Only 18 (54%) patients had diarrhea. The most common mode of infection is occult bacteremia without focal infection. Compared with data obtained from adult patients, the gastrointestinal manifestations appeared more frequently seen in pediatric patients. However, among the 18 who presented with diarrhea, 14 had concomitant bloodstream infection. Only 1 patient, who was a case of acute leukemia, died of S Choleraesuis sepsis. Resistance to ceftriaxone, ciprofloxacin, ampicillin, trimethoprim-sulfamethoxazole, and chloramphenicol was found in 6%, 28%, 88%, 76%, and 83% of the isolates, respectively. CONCLUSION. Children with S Choleraesuis infections usually presented with occult bacteremia with mild gastrointestinal involvement. The mortality of S Choleraesuis infections in previously healthy children is low. Ciprofloxacin resistance among S Choleraesuis isolates from pediatric patients was lower than that of isolates from adult patients. In view of the high rate of multidrug resistance, third-generation cephalosporins seem to be the drug of choice for treatment of invasive S Choleraesuis infections.

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