| 摘要: |
| 目的:回顾性分析小儿鼠伤寒沙门菌肠炎的临床特点及耐药情况,指导临床合理使用抗菌药物。方法:回顾性分析2011-2016年我院收治的162例鼠伤寒沙门菌肠炎患儿的临床资料及药敏数据,总结其临床特点及耐药情况。结果:共162例患儿大便分离培养出鼠伤寒沙门菌, 占同期大便分离沙门菌属的68.64%, 是沙门菌属的主要致病血清型, 其中116例(71.60%)有不洁饮食史。162例鼠伤寒沙门菌肠炎患儿中男109例(67.28%),女53例(32.72%),年龄1.12(0.25,5.00)岁,以婴儿为主(60.49%),夏季为发病高峰(58.64%)。本组鼠伤寒沙门菌肠炎患儿主要临床表现为发热(93.21%),大便含黏液及血(90.74%);实验室检查可见大便含不同程度的白细胞(95.06%)、红细胞(88.27%)及脓细胞(58.64%),多伴血C反应蛋白增高(65.43%)及白细胞计数增高(62.96%)。162株鼠伤寒沙门菌对抗菌药物的耐药率由低到高依次为: 头孢曲松(12.96%)、环丙沙星(14.81%)、头孢噻肟(17.28%)、复方磺胺甲唑(35.80%)、氨苄西林(81.48%)。18 株(11.11%) 对3种以上抗菌药物耐药,7株(4.32%)对所有抗菌药物均敏感。结论:鼠伤寒沙门菌是沙门菌属的主要致病血清型,鼠伤寒沙门菌肠炎好发于1岁以内的婴儿,夏季为发病高峰。本地区鼠伤寒沙门菌有耐药株及多重耐药株,对氨苄西林高度耐药,对第三代头孢菌素及含酶抑制剂的第三代头孢菌素较敏感。 |
| 关键词: 小儿 鼠伤寒沙门菌 肠炎 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.09.004 |
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| 基金项目: |
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| Clinical Characteristics and Drug Resistance of Salmonella Typhimurium Enteritis in 162 Children |
| Du Min, Xie Xiaoli |
| (Chengdu Women and Children's Central Hospital, Sichuan Chengdu 610019, China) |
| Abstract: |
| Objective: To retrospectively analyze the clinical characteristics and drug resistance of Salmonella typhimurium enteritis in children, so as to guide the clinical rational drug use. Methods: Retrospective analysis was conducted on clinical characteristics and drug susceptibility from 162 children with Salmonella typhimurium enteritis admitted into our hospital from 2011 to 2016. Results: Totally 162 cases of children were isolated and cultured from feces, accounting for 68.64% of the total in the meantime. They were the main pathogenic serotype of Salmonella, among which 116 cases (71.60%) had a history of unclean diet. Among the 162 children with Salmonella typhimurium enteritis, 109 (67.28%) were males and 53 (32.72%) were females. The age was 1.12 (0.25, 5.00) years old, mainly focus on infants (60.49%) and summer had the peak of incidence (58.64%). The main clinical manifestations of children with Salmonella typhimurium enteritis were fever (93.21%), mucus and blood (90.74%); laboratory examination revealed that the stool contained different levels of white blood cells (95.06%), red blood cells (88.27%) and pus cells (58.64%), increased C-reactive protein (65.43%) and increased WBC count (62.96%). The resistance rates of 162 strains of Salmonella typhimurium to antibiotics were as follows: ceftriaxone (12.96%), ciprofloxacin (14.81%), cefotaxime (17.28%), compound sulfamethoxazole (35.80%) and ampicillin (81.48%). There were 18 strains (11.11%) resistant to more than 3 antibiotics, and 7 strains (4.32%) were sensitive to all antibiotics. Conclusion: Salmonella typhimurium is the main pathogenic serotype of Salmonella. The incidence of Salmonella typhimurium enteritis in infants under the age of 1 year is high in summer. There are resistant strains and multi-drug resistant strains of Salmonella typhimurium in this region, which are highly resistant to ampicillin and sensitive to the third-generation cephalosporins and the third-generation cephalosporins containing enzyme inhibitors. |
| Key words: children Salmonella typhimurium enteritis |
