目的 了解成都市儿童侵袭性非伤寒沙门菌（non-typhoidal Salmonella, NTS）肠炎的临床特征和耐药情况，为临床合理用药和经验治疗提供参考。 方法 回顾性分析2022年1月—2023年12月四川省成都市粪便标本细菌培养出NTS的130例侵袭性细菌性肠炎患儿的临床资料，以及NTS的药敏试验结果。 结果 NTS感染主要集中在4~9月份（113例，86.9%），8月份为高峰期（36例，27.7%）。婴幼儿（月龄<36个月）占86.2%（112/130），主要症状为腹泻（130例，100%）、发热（123例，94.6%）和血便（112例，86.2%）。130株NTS对头孢曲松和头孢噻肟的敏感率分别为64.6%和63.8%。对哌拉西林他唑巴坦、呋喃妥因（硝基呋喃类）的敏感率均>90.0%。多重耐药菌株检出率为48.5%（63/130）；38例（29.2%）患儿使用第三代头孢菌素的临床疗效与药敏结果不一致。 结论 成都地区0~6岁儿童侵袭性NTS肠炎患病高峰在8月份，婴幼儿为高发人群。NTS耐药情况比较严峻，哌拉西林他唑巴坦可能是治疗儿童多重耐药NTS感染的有效选择，硝基呋喃类抗菌药物可能有望用于治疗多重耐药NTS感染。
Abstract
Objective To investigate the clinical characteristics and drug resistance profile of invasive non-typhoidal Salmonella (NTS) enteritis in children in Chengdu, China, providing a reference for rational drug use and empirical treatment in clinical practice. Methods A retrospective analysis was conducted on the clinical data of 130 children with invasive bacterial enteritis due to NTS identified by fecal bacterial culture and the results of drug sensitivity tests for NTS in Chengdu from January 2022 to December 2023. Results NTS infections were mainly observed from April to September (113 cases, 86.9%), with a peak in August (36 cases, 27.7%). Children aged <36 months accounted for 86.2% (112/130) of all cases, and the main symptoms were diarrhea (130 cases, 100%), fever (123 cases, 94.6%), and hematochezia (112 cases, 86.2%). The 130 NTS isolates exhibited a sensitivity rate of 64.6% to ceftriaxone and 63.8% to cefotaxime, and a sensitivity rate of >90.0% to piperacillin-tazobactam and nitrofurantoin (nitrofurans). The detection rate of multidrug-resistant strains was 48.5% (63/130), and the clinical efficacy of third-generation cephalosporins used in 38 patients (29.2%) was inconsistent with the results of drug sensitivity tests. Conclusions The peak of invasive NTS enteritis in children aged 0-6 years occurs in August in the Chengdu area, with a relatively high incidence rate in children aged <36 months. The situation of drug resistance is severe for NTS, and piperacillin-tazobactam may be an effective option for treating multidrug-resistant NTS infections in children, while nitrofuran antibiotics might be used to treat such infections.
关键词
肠炎 /
沙门菌 /
临床特点 /
药敏 /
儿童
Key words
Enteritis /
Salmonella /
Clinical characteristic /
Drug sensitivity /
Child
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