Clinical and drug sensitivity characteristics of invasive non-typhoidal Salmonella enteritis in children aged 0-6 years in Chengdu, China, 2022-2023
YANG Ling-Rong, ZHOU Chun-Ting, GUO Jing, WU Yu-Lu, XIONG Fu
Department of Pediatric Gastroenterology, Sichuan Provincial Women's and Children's Hospital/Women's and Children's Hospital Affiliated to Chengdu Medical College, Chengdu 610000, China
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.
YANG Ling-Rong,ZHOU Chun-Ting,GUO Jing et al. Clinical and drug sensitivity characteristics of invasive non-typhoidal Salmonella enteritis in children aged 0-6 years in Chengdu, China, 2022-2023[J]. CJCP, 2025, 27(3): 315-320.
Yue M, Zhao X, Hu X, et al. Genomic characterization of a multidrug-resistant Salmonella Rissen ST469 carrying blaCTX-M-55 gene and Tn6777 isolated from a paediatric patient in China[J]. J Glob Antimicrob Resist, 2023, 33: 238-241. PMID: 36878464. DOI: 10.1016/j.jgar.2023.02.024.
Kosek M, Bern C, Guerrant RL. The global burden of diarrhoeal disease, as estimated from studies published between 1992 and 2000[J]. Bull World Health Organ, 2003, 81(3): 197-204. PMID: 12764516. PMCID: PMC2572419.
Asgharpour F, Rajabnia R, Ferdosi Shahandashti E, et al. Investigation of class I integron in Salmonella infantis and its association with drug resistance[J]. Jundishapur J Microbiol, 2014, 7(5): e10019. PMID: 25147710. PMCID: PMC4138636. DOI: 10.5812/jjm.10019.
Abbas A, Barkhouse A, Hackenberger D, et al. Antibiotic resistance: a key microbial survival mechanism that threatens public health[J]. Cell Host Microbe, 2024, 32(6): 837-851. PMID: 38870900. DOI: 10.1016/j.chom.2024.05.015.
Lin Z, Yuan T, Zhou L, et al. Impact factors of the accumulation, migration and spread of antibiotic resistance in the environment[J]. Environ Geochem Health, 2021, 43(5): 1741-1758. PMID: 33123928. DOI: 10.1007/s10653-020-00759-0.
Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea[J]. Clin Infect Dis, 2017, 65(12): e45-e80. PMID: 29053792. PMCID: PMC5850553. DOI: 10.1093/cid/cix669.
Akshay SD, Deekshit VK, Mohan Raj J, et al. Outer membrane proteins and efflux pumps mediated multi-drug resistance in Salmonella: rising threat to antimicrobial therapy[J]. ACS Infect Dis, 2023, 9(11): 2072-2092. PMID: 37910638. DOI: 10.1021/acsinfecdis.3c00408.
Hengkrawit K, Tangjade C. Prevalence and trends in antimicrobial susceptibility patterns of multi-drug-resistance non-typhoidal Salmonella in Central Thailand, 2012-2019[J]. Infect Drug Resist, 2022, 15: 1305-1315. PMID: 35378891. PMCID: PMC8976529. DOI: 10.2147/IDR.S355213.
Gerber JS, Jackson MA, Tamma PD, et al. Policy statement: antibiotic stewardship in pediatrics[J]. J Pediatric Infect Dis Soc, 2021, 10(5): 641-649. PMID: 33595086. DOI: 10.1093/jpids/piab002.
Wang D, Guo Q, Yuan Y, et al. The antibiotic resistance of Helicobacter pylori to five antibiotics and influencing factors in an area of China with a high risk of gastric cancer[J]. BMC Microbiol, 2019, 19(1): 152. PMID: 31272365. PMCID: PMC6611032. DOI: 10.1186/s12866-019-1517-4.