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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.

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