2009～2011年北京市腹泻儿童沙门菌感染流行病学特征和耐药分析

Analysis of the epidemiological characteristics and drug resistance of Salmonella infection among children in Beijing from 2009 to 2011

目的了解2009～2011年北京市感染性腹泻患儿中沙门菌感染的流行病学特征和耐药情况。方法通过北京市肠道门诊监测系统采集感染性腹泻患儿粪便标本,进行沙门菌生化鉴定及血清学分型,同时采用Kirby-Bauer法进行药敏试验。结果北京市2009～2011年腹泻患儿粪便中共分离沙门菌53株,分为16种血清型,其中肠炎沙门菌、鼠伤寒沙门菌和阿贡纳沙门菌分别占32.08%、18.87%和13.21%。53株沙门菌株中男、女检出比为1.94︰1,1～岁占39.62%,2～岁占28.30%。53株沙门菌对头孢他啶和头孢曲松的敏感率均为96.23%,对头孢噻肟的敏感率为94.34%,对环丙沙星的敏感率为92.45%。结论北京市腹泻患儿沙门菌感染以1～2岁为主,男性儿童较高发。病原菌优势血清型为肠炎沙门菌。耐药分析显示致儿童腹泻沙门菌对三代头孢菌素类抗生素和环丙沙星仍较为敏感,已出现的环丙沙星耐药株为鼠伤寒沙门菌。

Objective To investigate the epidemiological characteristics and drug resistance of Salmonella infection among children in Beijing from 2009 to 2011.Methods Fecal specimens were collected from children with infectious diarrhea via a gastroenterology surveillance system and subjected to biochemical testing and serotyping.An antimicrobial resistance test was also performed on isolated strains via the Kirby-Bauer method.Results Fifty three salmonella strains were isolated from the feces of children with infectious diarrhea in Beijing from 2009 to 2011.The strains represented 16 serotypes.Of the strains,32.08% were S.enteritidis,18.87% were S.typhimurium,and 13.21% were S.agona.The male-to-female ratio for children with infectious diarrhea was 1.94︰1.Of the children,39.62% were 1 year old and older while 28.30% were 2 years old and older.Susceptibility results for the 53 salmonella strains indicated that susceptibility to ceftazidime and ceftriaxone was 96.23%,susceptibility to cefotaxime was 94.34%,and susceptibility to ciprofloxacin was 92.45%.Conclusion Most children with Salmonella infection in Beijing were 1 to 2 years of age,and boys had a high incidence of infection.The predominant pathogen was S.enteritidis.Analysis of antibiotic resistance revealed that strains were highly susceptible to third-generation cephalosporins and ciprofloxacin.Ciprofloxacin-resistant strains of S.typhimurium were evident.