Article in Japanese

A case of non-typhoidal Salmonella bacteremia caused by extended-spectrumβ-lactamase producing Salmonella Schwarzengrund with minimal gastrointestinal symptoms.

Taketo KASAI¹⁾, Takanori YANAI¹⁾, Takashi NISHIZAWA¹⁾

Non-typhoidal Salmonella (NTS) is an important causative agent of bacterial enteritis. Bacteremia occurs in about 1% to 5% of NTS infections, for which antibacterial treatment involves primary use of third-generation cephalosporins.
This paper reports a case of NTS bacteremia producing extended-spectrumβ-lactamase (ESBL), which involved minimal gastrointestinal symptoms that were difficult to treat with third-generation cephalosporins. A 12-year-old boy with an otherwise healthy constitution was admitted to this department with the chief complaint of persistent fever. While blood culture results indicated bacteremia caused by Gram-negative bacillus, the patient's symptoms did not improve with antimicrobial therapy, which included cefotaxime, whereupon ESBL-producing Salmonella Schwarzengrund was seen to cause the bacteremia. The infection was cured with a two-week administration of meropenem, after which no complications or recurrence of symptoms were observed.
With regard to ESBL-producing NTS; although the detection of ESBL-producing bacteria in stool has been reported in cases of NTS causing bacterial enteritis, this appears to be the first such case involving bacteremia in Japan.

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1) Department of Pediatrics, Yokohama Minami-kyosai Hospital

Key words	non-typhoidal Salmonella (NTS), extended-spectrum β-lactamase (ESBL), bacteremia, Salmonella Schwarzengrund
Received	July 9, 2018
Accepted	December 28, 2018

31 (2)：119─123,2019