专家笔谈

儿童非伤寒沙门菌胃肠炎抗感染策略

  • 黄辉 ,
  • 邓莉
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  • 首都儿科研究所附属儿童医院感染科(北京 100020)

收稿日期: 2023-07-18

  网络出版日期: 2023-11-08

Anti-infective strategies of non-typhoid Salmonella gastroenteritis in children

  • Hui HUANG ,
  • Li DENG
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  • Department of Infectious Diseases, Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing 100020, China

Received date: 2023-07-18

  Online published: 2023-11-08

摘要

非伤寒沙门菌(nontyphoidal Salmonella,NTS)属于沙门菌属的肠道沙门菌种,感染人类后主要引起急性胃肠炎的表现,5岁以下儿童易感,夏季多见,腹泻与发热是最常见症状,大便性状多样。最常见的血清型有肠炎沙门菌、鼠伤寒沙门菌和纽波特沙门菌,多数患者仅需补液及纠正电解质紊乱等对症治疗,存在侵袭性感染风险的人群、明确鼠伤寒沙门菌感染应考虑抗菌药物治疗,儿童首选抗生素为三代头孢菌素。近年国内NTS耐药率有增加趋势,疑似感染者尽可能在开始抗感染治疗前完善病原学检测。非伤寒沙门菌感染的临床诊疗仍存在许多争议,提高临床病例病原学确诊率、推广快速病原诊断方法、开展高循证质量临床试验,有助于规范非伤寒沙门菌胃肠炎的诊治。

本文引用格式

黄辉 , 邓莉 . 儿童非伤寒沙门菌胃肠炎抗感染策略[J]. 临床儿科杂志, 2023 , 41(11) : 811 -814 . DOI: 10.12372/jcp.2023.23e0646

Abstract

Non-typhoid Salmonella belongs to Salmonella enterica, which mainly causes acute gastroenteritis after infecting human beings, and children under 5 years old are susceptible to it. It is more common in summer. Diarrhea and fever are the most common symptoms, fecal traits are diverse, and the most common serotypes are Salmonella enteritidis, Salmonella typhimurium and Salmonella Newport. Most patients only need symptomatic treatment such as fluid replacement and electrolyte disturbance correction. Antibacterial drugs should be considered for people with invasive infection risk and Salmonella typhimurium infection, the third-generation cephalosporin is the first choice for children. In recent years, the drug resistance rate of NTS in China has an increasing trend, and patients with suspected infection should try their best to improve the etiological detection before starting anti-infective treatment. There are still many controversies in the clinical diagnosis and treatment of non-typhoid Salmonella infection. Improving the etiological diagnosis rate of clinical cases, promoting rapid pathogen diagnosis methods, and carrying out high-quality evidence-based clinical trials will help to standardize the diagnosis and treatment of non-typhoid Salmonella gastroenteritis.

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