2018年广州市南沙区儿童粪便分离沙门菌的流行病学特征及耐药性

Epidemic Characteristics and Antimicrobial Resistance of Salmonella Strains Isolated from Feces of Children in Nansha District of Guangzhou,2018

目的了解广州市南沙区儿童粪便分离沙门菌的流行病学特征及其对抗菌药物的敏感性,为疾病防治和临床选用抗菌药物提供依据。方法 从2018年1—12月广州市第一人民医院南沙医院941例儿童送检粪便标本中分离沙门菌127株,分析检出沙门菌儿童的年龄及检出时间的分布特点、用沙门菌诊断血清检测其血清型分布,并用自动仪器法检测其药物敏感性。结果 粪便检出沙门菌的儿童男女比例为1.4 : 1,年龄分布为16 d^10岁,年龄主要集中在0~3岁(90.6%),<1岁最多(48.0%),1~2岁其次(35.4%)。检出时间集中在6~10月(64.6%),8、9月最多。血清型主要为O4群。对左氧氟沙星和复方新诺明的敏感率分别为47.2%和59.1%,三四代头孢菌素的敏感率为84%~92.1%,对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、阿莫西林/克拉维酸的敏感性分别为 92.9%、86.6%、72.4%,未发现有对亚胺培南、厄他培南耐药菌。结论 本地区沙门菌对左氧氟沙星、复方新诺明敏感性较低,对三四代头孢菌素、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、碳青霉烯类敏感性较高。临床要根据药物敏感性结果和疗效调整用药。

Objective To understand the epidemiological characteristics and antimicrobial susceptibility of Salmonella isolated from feces of children in Nansha district of Guangzhou,and to provide a basis for the prevention of Salmonella infection and clinical selection of antimicrobial agents. Methods A total of 127 strains of Salmonella were isolated from 941 fecal samples sent by Nansha Hospital of Guangzhou First People’s Hospital from January to December 2018.The distribution characteristics of age and detection time of Salmonella were analyzed.The serotype distribution was detected by diagnostic serum,and the drug sensitivity was measured by automatic instrument method. Results The ratio of boys to girls with Salmonella detected in feces was 1.4 : 1 .The age distribution ranged from 16 days to 10 years.Salmonella were mainly found in children younger than 3 years(90.6%),mostly in those under 1 year old(48.0%),followed by those aged 1 to 2 years old(35.4%).The detection time was mainly from June to October( 64.6%),mostly in August/September.The main serotype was O4 group.The Salmonella strains exhibited a sensitivity of 47.2% to levofloxacin,59.1% to trimethoprim/sulfamethoxazole,84%-92.1% to the third and fourth generation cephalosporins,92.9% to piperacillin/tazobactam, 86.6% to cefoperazone/sulbactam,and 72.4% to amoxicillin/clavuric acid.No bacteria isolated were resistant to imipenem and ertapenem. Conclusion The Salmonella isolated form local children were comparatively less sensitive to levofloxacin and trimethoprim/sulfamethoxazole,but highly sensitive to the third and fourth generation cephalosporins,piperacillin/tazobactam,cefperazone/sulbactam and carbapenems.Therefore,clinicians should adjust the medication according to drug sensitivity results and curative efficacies.