临床儿科杂志 ›› 2016, Vol. 34 ›› Issue (4): 246-.doi: 10.3969 j.issn.1000-3606.2016.04.002

• 消化系统疾病专栏 • 上一篇    下一篇

儿童沙门菌感染临床特点及耐药模式

王庭庭1, 徐飞2, 李玫1, 郭红梅1   

  1. 南京医科大学附属南京儿童医院1. 消化科,2. 微生物室(江苏南京 210008)
  • 收稿日期:2016-04-15 出版日期:2016-04-15 发布日期:2016-04-15
  • 通讯作者: 郭红梅 E-mail:guohongmei2026@aliyun.com

Clinical characteristics and drug resistance pattern of Salmonella infection in children

WANG Tingting1, XU Fei2, LI Mei1, GUO Hongmei1   

  1. (. Department of Gastroenterology, 2. Microbial Chamber, Nanjing Children’s Hospital Affiliated Nanjing Medical University, Nanjing 210008, Jiangsu, China
  • Received:2016-04-15 Online:2016-04-15 Published:2016-04-15

摘要: 目的 了解儿童沙门菌感染的流行特征和耐药模式。方法 分析2012 年2 月—2014 年9 月住院且粪便细菌培养出沙门菌菌株患儿的临床特点,以及沙门菌的血清型和药敏试验结果。结果 从2 678 例住院患儿粪便标本中检测出87 株沙门菌,5—9 月份共检测出64 株(73.56%)。87 例沙门菌阳性患儿中,男58 例、女29 例,其中< 2 岁的68 例(78.16%)。临床症状主要为脓血便65 例(74.71%),发热72 例(82.76%)。合并有轮状病毒感染10 例(11.49%)。经沙门菌血清学鉴定,分别为布利丹沙门菌6株,肠炎沙门菌6株,鼠伤寒沙门菌5株,亚利桑那沙门菌3株,奥拉宁堡沙门菌2株,策维埃沙门菌2株,纽兰芝沙门菌、德比沙门菌、阿哥纳沙门菌、布伦登芦普沙门菌、埃可沙门菌各1 株。药敏试验结果显示,沙门菌对头孢唑啉、头孢呋辛、庆大霉素的耐药率分别为94.25%、87.36%、87.36%,有26 株(29.89%)沙门菌呈多重耐药。结论 < 2 岁儿童沙门菌易感,男性患儿居多,主要表现为脓血便、发热,有部分合并轮状病毒感染;沙门菌血清型以布利丹沙门菌、肠炎沙门菌和鼠伤寒沙门菌多见,对多种抗生素耐药,甚至多重耐药。

Abstract: Objective To explore the epidemiological characteristics and drug resistance pattern of Salmonella infection in children. Methods The clinical features and the results of serotype and drug sensitive tests in hospitalized children having Salmonella strains detected in fecal samples were analyzed from February 2012 to September 2014. Results A total of 87 strains of salmonella were detected in the fecal samples of 2678 participants. Sixty-four strains (73.56%) were detected from May to September. Among 87 salmonella infectious cases (58 males and 29 females), 68 cases (78.16%) were under 2 years old. The major clinical symptoms were mucopurulent stool (65 cases, 74.17%) and fever (72 cases, 82.76%), and there also was rotavirus infection (10 cases, 11.49%). According to serological identification, there were 6 strains of Salmonella Buridan, 6 strains of Salmonella enteritidis, 5 strains of Salmonella typhimurium, 3 strains of Salmonella Arizona, 2 strains of Salmonella oranienburg, 2 strains of Salmonella Tsevie, and one strain each of New Laneige Salmonella, Salmonella derby, Salmonella agona, and Salmonella braenderup. Drug sensitivity tests showed that the rates of Salmonella resistant to cefazolin, cefuroxime, and gentamicin were 94.25%, 87.36%, and 87.36%, respectively. Moreover, 26 strains (29.89%) were multi-drug resistant. Conclusions Children under 2 years old are susceptible to Salmonella infection with males as majority. The common symptoms were mucopurulent stool and fever, and some may be accompanied with rotavirus infection. The common serotypes were Salmonella Buridan, Salmonella enteritidis, and Salmonella typhimurium. The salmonella are resistant to multiple antibiotics and even multi-drug resistant.