Related Experiment Videos
Yersinia enterocolitica infection in children
J A Hoogkamp-Korstanje1, V M Stolk-Engelaar
1Department of Medical Microbiology, St. Radboud Hospital, Nijmegen, The Netherlands.
Insights
Yersinia enterocolitica infections in children present with varied enteric and extramesenteric forms. Older children (>6 years) experience more severe illness, suggesting antibiotic use may be warranted.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Yersinia enterocolitica is a significant bacterial pathogen causing gastrointestinal illness in children.
- Infections can manifest with diverse clinical presentations, ranging from simple enteritis to severe systemic complications.
Purpose of the Study:
- To prospectively investigate the clinical spectrum, diagnostic methods, and outcomes of Yersinia enterocolitica infections in a pediatric cohort.
- To identify risk factors for severe disease and guide therapeutic strategies.
Main Methods:
- Prospective study of 125 children with Yersinia enterocolitica infection.
- Clinical data collection on presentation, course, and complications.
- Diagnostic evaluation included bacterial culture, serological tests (agglutinin, anti-Yersinia outer membrane proteins IgA/IgG), and antigen detection in biopsies.
Main Results:
- Enteric forms (enteritis, pseudoappendicitis, ileitis) were most common (92%).
- Extramesenteric manifestations (arthritis, lymphadenopathy, erythema nodosum) and severe forms were more frequent in children >6 years (P < 0.001).
- Detection of anti-Yersinia outer membrane proteins antibodies and antigen in biopsies showed high diagnostic accuracy (98% and 85%, respectively), outperforming agglutinin tests.
Conclusions:
- Yersinia enterocolitica infection in children exhibits age-dependent severity, with older children facing higher risks of complications.
- Advanced diagnostic techniques offer superior sensitivity for Yersinia enterocolitica detection.
- Antibiotic therapy may be beneficial for Yersinia enteritis in children aged 6 years and older due to the potential for serious complications.
Abstract:
The clinical presentation, course and outcome of Yersinia enterocolitica infection was studied prospectively in 125 children. Enteric forms occurred in 114 children (92 enteritis, 20 pseudoappendicitis, 2 chronic ileitis), of whom 17 also had extramesenteric manifestations; 11 children had one or more extramesenteric forms without enteric disease. Enteritis occurred more frequently in young children whereas serious forms and extramesenteric forms were more common in children older than 6 years of age (P < 0.001). Arthritis was observed in 13 children and extensive lymphadenopathy in 11; 1 child had septicemia with pleurisy, 1 had vasculitis, 1 had cholecystitis and 4 had erythema nodosum. Diagnosis was established by positive culture in 100 (80%) children and by agglutinin test in 11 of 45 (24%), demonstration of circulating specific anti-IgA and anti-IgG to Yersinia outer membrane proteins in 47 of 48 (98%) and detection of antigen in biopsies in 28 of 33 (85%) children. The 2 latter methods were superior to the agglutinin test. Serotype O3 and O9 predominated. The frequency and seriousness of complications may justify the use of antibiotics for Yersinia enteritis in children 6 years of age or older.