儿童肠道沙门菌感染临床特征及药敏结果分析

Analysis of clinical characteristics and drug sensitivity results of intestinal salmonella infection in children

目的本文为单中心回顾性分析研究,总结了海口市妇幼保健院患儿肠道沙门菌感染的临床特点及抗菌药物的耐药情况,为海口市妇幼保健院儿科医师临床诊治此类疾病提供了理论指导。方法对2015年1月—2020年12月在海口市妇幼保健院儿科住院的198例肠道沙门菌感染的腹泻患儿临床资料和药敏结果进行回顾性分析。结果198例患儿中,男性103例(52.02%),女性95例(47.98%),年龄1个月~13岁;<1岁91例(45.96%),1~3岁50例(25.25%),3~6岁35例(17.68%),>6岁22例(11.11%);发病季节:1~3月38例(19.19%),4~6月55例(27.78%),7~9月62例(31.31%),10~12月43例(21.72%);有86例患儿发生93例次肠道外损害和并发12例次呼吸道感染及2例次败血症,其中,<1岁有53例次(26.77%),1~3岁29例次(14.65%),3~6岁17例次(8.59%),>6岁8例次(4.04%);患儿来源:城区儿童65例(32.83%),农村儿童133例(67.17%);药敏结果:198株沙门菌对亚胺培南敏感(100%)、15株对哌拉西林舒巴坦钠耐药(7.58%)、13株对头孢吡肟耐药(6.57%)、26株对左氧氟沙星耐药(13.13%)、130株对氨苄西林耐药(65.66%)、158株对阿米卡星耐药(79.80%)、78株对复方磺胺甲恶唑耐药(39.39%)、70株对环丙沙星耐药(35.35%)。结论小儿肠道沙门菌感染大多发生在1岁以下的患儿,男性患儿为主,发病季节多在4~6月和7-9月两个时段,婴幼儿容易发生肠道外器官损害和并发症,发病地区农村儿童多于城区儿童,药敏结果显示对亚胺培南完全敏感,对哌拉西林舒巴坦钠和头孢吡肟高度敏感,对阿米卡星、氨苄西林、复方磺胺甲恶唑、环丙沙星高度耐药。因此,对于沙门菌感染的腹泻应根据药敏结果结合患儿的实际情况选择适合的抗菌药,以免延误治疗。

Objective This paper summaries the clinical characteristics of intestinal infection and antimicrobial resistance in children with infants in this hospital,and provides theoretical guidance for pediatricians in the hospital to diagnose and treat such disease.Methods A retrospective analysis of clinical data and drug sensitivity results of 198 cases of intestinal salmonella infection in our pediatric hospital in January 2015-December 2020 was carried out.Results Of the 198 cases,there were 103 males(52.02%)and 95 females(47.98%),aged 1 month old to 13 years old,of which 91 cases(45.96%)within 1 year old,1~3 years 50 cases(25.25%),3~6 years 35 cases(17.68%),over 6 years old 22 cases(11.11%).Duration:38 cases(19.19%)in January-March;55 cases(27.78%)in April-June;62 cases(31.31%)in July-September;43 cases(21.72%)in October-December.There were 93 cases of intestinal damage and 12 cases of secondary respiratory infections and 2 cases of sepsis in 86 children.in children 107 timess.Thereinto,there were 53 cases(26.77%)of within 1 year old,29 cases(14.65%)of 1~3 years old,17 cases(8.59%)of 3~6 years old,and 8 cases(4.04%)over 6 years old.Source:65 cases of urban children(32.83%),and 133 cases ofrural children(67.17%).Drug sensisitivity results:198 cases salmonella strains were sensitivity to imipenem(100%),15 strains were resistant to piperacillin sulbactam sodium(7.58%),13 strains were resistant cefepime(6.57%),26 strains were resistant to levofloxacin(13.13%),130 strains were resistant to ampicillin(65.66%),158 strainswere resistant to amikacin(79.80%),78 strains were resistant cotrimoxazole(39.39%),70 strains were resistant to ciprofloxacin(35.35%).Conclusion Infection of intestinal Salmonella in children occurs most often in children under one year of age,male children mainly,the onset season in April-June and July-September two times,infants and young children are prone to damage to intestinal organs and complications.the onset of regional rural children more than urban children,the results of drug sensitivity showed complete sensitivity to imipenem,hypersensitive to piperacillin sulbactam sodium and cefepime,high drug resistance to amikacin,ampicillin,cotrimoxazole,ciprofloxacin.therefore,for salmonella infection diarrhea should be according to choose suitable antimicrobial drugs,so as not to delay treatment.