Article in Japanese

Clinical feature, O-antigen serotype and antimicrobial susceptibility of Salmonella enteritis in children presenting to the pediatric department of a regional hospital between 2014 and 2018

Takuya AKANO¹⁾, Naoko NISHIMURA¹⁾, Arika MURASE¹⁾, Mako YAMADA¹⁾, Takuma ANDO¹⁾, Takuto ITO¹⁾, Suguru TAKEUCHI¹⁾, Kensei GOTOH¹⁾, Koji TAKEMOTO¹⁾, Takao OZAKI¹⁾

Salmonella is an important causative agent of bacterial enteritis in children. In this study, we retrospectively investigated 80 patients with gastroenteritis who visited pediatric department of a regional hospital between 2014 and 2018 and had Salmonella isolated in stool or blood samples. For all isolated strains (n=80), O-antigen serotype was examined, and MIC values of 14 antimicrobials (ABPC, CFDN, CDTR, CPDX, CTRX, CAZ, CMZ, PAPM, SBT/ABPC, TAZ/PIPC, MINO, AZM, TFLX, FOM) were measured and assessed as susceptible, intermediate, or resistant according to the Clinical and Laboratory Standards Institute criteria.
Patients had a median age of 6 years and 4 months (range: 10 months–14 years). A seasonal peak incidence was observed during the summer months from July to September. The main symptoms were fever (95%), diarrhea (93%), abdominal pain (73%), vomiting (25%), and hematochezia (21%). Fifty-six (70%) patients required hospitalization, and two patients each presented with bacteremia and febrile convulsions. Serotype O4 was the predominant isolated strain (37 strains; 46%), followed by serotype O7 (19 strains), and serotype O8 (14 strains). Resistance to antimicrobials (intermediate and resistant) was observed in 6.3% each for ABPC and CFDN, 7.5% each for CPDX, CTRX, and CAZ, 5% for SBT/ABPC, 1.3% each for TAZ/PIPC and CMZ, and 20% for MINO. The emergence of strains resistant to third-generation cephem antimicrobials, which were not detected in our previous two investigations (2004: n=17; 2010: n=23), is concerning, and continued surveillance of the trends is needed.

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1) Department of Pediatrics, Konan Kosei Hospital

Key words	Salmonella enteritis, O-antigen serotype, antimicrobial susceptibility, cephem antimicrobial resistant strain
Received	December 22, 2020
Accepted	April 1, 2021

33 (2)：84─92,2021