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

doi:10.7499/j.issn.1008-8830.2408085

PDF(615 KB)

Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (3) : 315-320. DOI: 10.7499/j.issn.1008-8830.2408085

CLINICAL RESEARCH

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

Author information +

History +

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.

Key words

Enteritis / Salmonella / Clinical characteristic / Drug sensitivity / Child

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

YANG Ling-Rong, ZHOU Chun-Ting, GUO Jing, WU Yu-Lu, XIONG Fu. Clinical and drug sensitivity characteristics of invasive non-typhoidal Salmonella enteritis in children aged 0-6 years in Chengdu, China, 2022-2023[J]. Chinese Journal of Contemporary Pediatrics. 2025, 27(3): 315-320 https://doi.org/10.7499/j.issn.1008-8830.2408085

References

1 Zhao X, Hu M, Zhang Q, et al. Characterization of integrons and antimicrobial resistance in Salmonella from broilers in Shandong, China[J]. Poult Sci, 2020, 99(12): 7046-7054. PMID: 33248621. PMCID: PMC7705031. DOI: 10.1016/j.psj.2020.09.071.
2 Achtman M, Wain J, Weill FX, et al. Correction: multilocus sequence typing as a replacement for serotyping in Salmonella enterica[J]. PLoS Pathog, 2020, 16(10): e1009040. PMID: 33085727. PMCID: PMC7577496. DOI: 10.1371/journal.ppat.1009040.
3 陈民钧, 王澎. 介绍沙门菌的新命名系统[J]. 中华检验医学杂志, 2009, 32(3): 359-360. DOI: 10.3760/cma.j.issn.1009-9158.2009.03.034.
4 李红秋, 贾华云, 赵帅, 等. 2021年中国大陆食源性疾病暴发监测资料分析[J]. 中国食品卫生杂志, 2022, 34(4): 816-821. DOI: 10.13590/j.cjfh.2022.04.029.
5 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.
6 李国钢, 李佳俊, 赵升. 东阳地区儿童沙门菌感染的流行病学调查及耐药性分析[J]. 中国现代医生, 2018, 56(6): 135-137.
7 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.
8 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.
9 胡豫杰, 王伟, 闫韶飞, 等. 2015年分离自中国大陆食品的1 070株沙门菌耐药性分析[J].中国食品卫生杂志, 2017, 29(6): 647-652. DOI: 10.13590/j.cjfh.2017.06.003.
10 国家卫生健康委办公厅, 国家中医药管理局办公室. 儿童急性感染性腹泻病诊疗规范（2020年版）[J]. 全科医学临床与教育, 2020, 18(11): 964-967. DOI: 10.13558/j.cnki.issn1672-3686.2020.011.002.
11 尚红, 王毓三, 申子瑜. 全国临床检验操作规程[M]. 4版. 北京: 人民卫生出版社, 2015: 173.
12 CLSI. Performance standards for antimicrobial susceptibility testing; twenty-fourth informational supplement: M100-S24[S]. Malvern, PA, USA: CLSI, 2014.
13 全国腹泻病防治学术研讨会组织委员会. 腹泻病疗效判断标准的补充建议[J]. 中国实用儿科杂志, 1998, 13(6): 384.
14 彭淑萍, 李波, 廖国东, 等. 广东省茂名市儿童食源性沙门菌感染的血清型分型和耐药特征[J]. 中国热带医学, 2020, 20(7): 661-665. DOI: 10.13604/j.cnki.46-1064/r.2020.07.18.
15 许云敏, 杜艳, 单斌, 等. 2005—2014年CHINET沙门菌属细菌耐药性监测[J]. 中国感染与化疗杂志, 2016, 16(3): 294-301. DOI: 10.16718/j.1009-7708.2016.03.009.
16 陈玲, 陈小丽, 吴佳音, 等. 小儿沙门菌感染临床特点及耐药性分析[J]. 中国当代儿科杂志, 2018, 20(11): 921-924. PMID: 30477623. PMCID: PMC7389025. DOI: 10.7499/j.issn.1008-8830.2018.11.008.
17 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.
18 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.
19 张建群, 罗学辉, 黄绍军. 浙江省余姚市腹泻儿童沙门菌感染流行病学特征和耐药分析[J]. 疾病监测, 2015, 30(9): 776-779. DOI: 10.3784/j.issn.1003-9961.2015.09.018.
20 何萍, 张馨, 郑秀秀, 等. 腹泻儿童非伤寒沙门菌的耐药性及毒力基因分析[J]. 中国人兽共患病学报, 2023, 39(4): 340-346. DOI: 10.3969/j.issn.1002-2694.2023.00.025.
21 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.
22 缪晓辉, 冉陆, 张文宏, 等. 成人急性感染性腹泻诊疗专家共识[J]. 中华消化杂志, 2013, 33(12): 793-802. DOI: 10.3760/cma.j.issn.0254-1432.2013.12.001.
23 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.
24 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.
25 中国碳青霉烯耐药肠杆菌科细菌感染诊治与防控专家共识编写组, 中国医药教育协会感染疾病专业委员会, 中华医学会细菌感染与耐药防控专业委员会. 中国碳青霉烯耐药肠杆菌科细菌感染诊治与防控专家共识[J]. 中华医学杂志, 2021, 101(36): 2850-2860. DOI: 10.3760/cma.j.cn112137-20210219-00438.
26 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.
27 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.
28 李傍娣, 莫顺华. 临床药效与药敏试验结果不符原因分析[J]. 宜春学院学报, 2011, 33(12): 116-117. DOI: 10.3969/j.issn.1671-380X.2011.12.049.