Pediatr Gastroenterol Hepatol Nutr.  2015 Jun;18(2):85-93. 10.5223/pghn.2015.18.2.85.

Differences in Clinical and Laboratory Findings between Group D and Non-Group D Non-Typhoidal Salmonella Gastroenteritis in Children

• Park HK
• Rhie K
• Yeom JS
• Park JS
• Park ES
• Seo JH
• Lim JY
• Park CH
• Woo HO
• Youn HS
• Kang KR
• Park JJ

• KMID: 2315554
• DOI: http://doi.org/10.5223/pghn.2015.18.2.85

Abstract

PURPOSE
To investigate the differences in clinical features and laboratory findings between group D and non-group D non-typhoidal Salmonella (NTS) gastroenteritis in children.
METHODS
A retrospective chart review of children diagnosed with NTS confirmed by culture study was performed. The clinical features and laboratory findings of group D and non-group D NTS were compared.
RESULTS
From 2003 to 2012, 75 cases were diagnosed as NTS at our center. The number of group D and non-group D patients was 45 and 30, respectively. The mean age was higher in group D than in non-group D patients (5.1 years vs. 3.4 years, p=0.038). Headaches were more frequently observed (p=0.046) and hematochezia was less frequently observed (p=0.017) in group D than in non-group D NTS gastroenteritis patients. A positive Widal test result was observed in 53.3% of group D and 6.7% of non-group D NTS cases (O-titer, p=0.030; H-titer, p=0.039). There were no differences in white blood cell counts, level of C-reactive protein and rate of antimicrobial resistance between group D and non-group D cases.
CONCLUSION
The more severe clinical features such as headache, fever, and higher Widal titers were found to be indicative of group D NTS gastroenteritis. Additionally, group D NTS gastroenteritis was more commonly found in older patients. Therefore, old age, fever, headache, and a positive Widal test are more indicative of group D NTS than non-group D NTS gastroenteritis. Pathophysiological mechanisms may differ across serologic groups.

Keyword

Salmonella infection; Salmonella enterica; Gastroenteritis

MeSH Terms

C-Reactive Protein
Child*
Fever
Gastroenteritis*
Gastrointestinal Hemorrhage
Headache
Humans
Leukocyte Count
Retrospective Studies
Salmonella enterica
Salmonella Infections
Salmonella*
C-Reactive Protein

Figure

• 

  Fig. 1 Annual incidence rates of non-typhoidal Salmonella (NTS) gastroenteritis. The incidence rate of non-typhoidal salmonellosis increased from 2003 to 2012 (p=0.033). The most commonly isolated NTS serogroup was group D. Group D was the most isolated and then were isolated by group B, group C, group E.

• 

  Fig. 2 Monthly Incidence rate of non-typhoidal salmonellosis. The incidence rate was highest in May and was higher from July to October compared with other months (p=0.007).

• 

  Fig. 3 Number of group D and non-group D non-typhoidal Salmonella gastroenteritis patients according to age. The peak occurrence was observed in children aged 2 and 3 years old in both groups. In children under the age of 5, there were more non-group D cases than group D cases.

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