Yersinia enterocolitica infection in children

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.