Abstract
Generalized infections with YE are relatively uncommon. Iron overload has been described as a major determinant of dissemination in YE infection. Recently a flurry of clinical reports have suggested that the supply of exogenous siderophores, such as desferrioxamine B, may trigger the development of systemic Yersiniosis. We report our data based upon a 10-year continuous surveillance of human Yersiniosis in Italy. Eighty-one per cent(9/11)of YE septicemia occurred in beta-thaiassemia major children; YE peritonitis was exclusively observed in these patients(4/4). All but one cases of septicemia were associated with acute enteritis. Mesenteric adenitis was identified by laparotomy in all 4 patients with peritonitis, as well as in the last case of sepsis. Of the 13 children with generalized infection, 6 had history of splenectomy; 10 were on deferoxamine(DFX)treatment, while 3 were not. One fatal case was observed in the group on DFX treatment. Through our survey, we also received 474 human isolates recovered from fecal specimens. Only 15 of these were from betathalassemia children who were on daily treatment with subcutaneous DFX and were affected with non-septic clinical conditions, such as acute enteritis(11), abdominal discomfort(3), and mesenteric adenitis(l). In such instances, despite DFX therapy,intestinal infection did not lead to a generalized form. All isolates from the 28 thalassemic children belonged to human pathogenic strains(03 and 09). Thus our experience indicates that iron overload in itself account for the susceptibility of the human host to generalized YE infection, while DFX is only one of several factors that contribute to virulence of the organism.
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Chiesa, C., Pacifico, L., Cianfrano, V. et al. 86 GENERALIZED YERSINIA ENIEROCOLITICA(YE) INFBCTION IN THALASSEMIC CHILDREN. Pediatr Res 24, 275 (1988). https://doi.org/10.1203/00006450-198808000-00112
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DOI: https://doi.org/10.1203/00006450-198808000-00112