Background. Yersinia enterocolitica can cause illness ranging from self-lim
ited enteritis to life-threatening systemic infection. The present study wa
s undertaken to review the epidemiology, clinical manifestations, complicat
ions and outcome of Y. enterocolitica enteritis in children seen at a large
children's hospital.
Methods. The project consisted of a retrospective chart review of medical a
nd microbiologic records of all children with stool cultures positive for Y
. enterocolitica during a 7-year period.
Results. The review included 142 patients with Y. enterocolitica enteritis.
Patients' ages ranged from 18 days to 12 years, and the majority (85%) wer
e younger than 1 year, Most patients presented during November, December an
d January, History of exposure to chitterlings (raw pork intestines) at hom
e was elicited in 25 of 30 cases, Y, enterocolitica accounted for 12.6% (14
2 of 1120) of all bacterial intestinal pathogens isolated during the study
period. Blood cultures were positive in 7(9%) of 78 patients; 6 were younge
r than 1 year and one 12-year-old had sickle cell disease. Of 132 isolates
tested all were susceptible to trimethoprim-sulfamethoxazole, tobramycin an
d gentamicin; the majority were susceptible to cefotaxime (99%), ceftazidim
e (89%) and cefuroxime (88%), All bacteremic patients responded to cefotaxi
me treatment. Follow-up evaluation of 40 ambulatory patients revealed no di
fference in clinical improvement between those treated with oral trimethopr
im-sulfamethoxazole (17 of 23) and those who were not treated (8 of 17) (P
= 0.1).
Conclusion. Y. enterocolitica is an important cause of enteritis in our you
ng patient population during the winter holidays, Exposure of infants to ch
itterlings appears to be a risk factor. Infants younger than 3 months are a
t increased risk for bacteremia, Cefotaxime is effective in the treatment o
f Y, enterocolitica bacteremia; however, the role of oral antibiotics in th
e management of enteritis needs further evaluation.