Salmonella enterica serotype Choleraesuis infection in a medical center in northern Taiwan

Shun Chiu, Cheng-Hsun Chiu, Tzou-Yien Lin
Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Childrens Hospital, Taoyuan, Taiwan, ROC

Received: April 11, 2003 Revised: May 14, 2003 Accepted: June 9, 2003

Corresponding author: Dr. Cheng-Hsun Chiu, Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Childrens Hospital, 5 Fu-Hsin Street, Kweishan, Taoyuan, Taiwan 333, ROC. E-mail:

This retrospective study was conducted in order to determine the clinical and microbiologic features of infection with Salmonella enterica serotype Choleraesuis. Between March 1999 and December 2002, 55 patients with 66 isolates were enrolled for analysis. The ratio of males to females was 2.2:1. Most patients were older than 60 years (56%) and had underlying diseases (78%), such as diabetes mellitus, malignancy, and peptic ulcer. Fever (85%) was the most common clinical manifestation, followed by abdominal pain/fullness (31%). The gastrointestinal manifestations, including nausea/vomiting or diarrhea, accounted for only 13% and 11% of patients, respectively. S. enterica serotype Choleraesuis was extremely invasive, with a high predilection to cause bacteremia (78% of the isolates were from blood). Various types of metastatic focal infections were found, including infected arterial aneurysm, osteomyelitis, septic arthritis, urinary tract infection and wound infection. The crude mortality rate was 18% (10 deaths in 55 cases). Nearly all isolates were susceptible to the third-generation cephalosporins. A higher resistance rate to commonly used antimicrobial agents was found with ampicillin (85%, 56/66), trimethoprim-sulfamethoxazole (81%, 40/49), chloramphenicol (96%, 47/49), and ciprofloxacin (49%, 30/61). In view of the emergence of fluoroquinolone resistance, the third-generation cephalosporins appear to be the best choice for treatment of invasive infections caused by this organism.

Key words: Bacteremia, infected aneurysm, Salmonella enterica, Taiwan

J Microbiol Immunol Infect 2004;37:99-102.