2015—2019年丽水市中心医院患儿粪便沙门菌分离情况及其耐药性分析

Isolation and drug resistance analysis of Salmonella faecalis in children from Lishui Central Hospital from 2015 to 2019

目的统计分析2015—2019年就诊于丽水市中心医院患儿粪便沙门菌的分离情况及其耐药性,为我院儿童合理用药提供参考依据。方法回顾性分析2015—2019年丽水市中心医院儿科送检粪便标本中沙门菌的分离情况及其对常用抗菌药物的耐药性结果。结果2015—2019年共从儿童粪便中分离出169株沙门菌。患儿男女比例为1.25:1;患儿年龄段呈偏态分布,以<3岁的婴幼儿为主,占80.5%(136/169);季节分布以秋季为主,夏季次之;81.7%(138/169)的患儿因胃肠道不适就诊。169株沙门菌共检测到22个血清型,以鼠伤寒沙门菌分离率最高,为51.5%(87/169),其次为肠炎沙门菌,为16.6%(28/169)。对氨苄西林、复方磺胺甲恶唑、头孢噻肟、环丙沙星和氯霉素的平均耐药率分别为85.8%、42.6%、19.5%、8.3%和39.1%,5年间沙门菌对氨苄西林、复方磺胺甲恶唑和氯霉素的耐药率呈上升趋势(P<0.05),对环丙沙星的耐药率呈下降趋势(P<0.05),未分离到碳青霉烯类耐药菌株。结论本院感染沙门菌的患儿以3岁以下婴幼儿多见;夏秋季为多发季节;分离到的沙门菌中最常见为鼠伤寒沙门菌;同时对一些抗菌药物的耐药性有明显改变。临床应根据实际情况选用合适的抗菌药物用于治疗,相关部门应加强对儿童沙门菌感染的监控与防治工作。

Objective Statistical analysis of the isolation and drug resistance of Salmonella from pediatric fecal specimens in our hospital from 2015 to 2019 was performed to provide a reference for children’s reasonable medication in our hospital.Methods Retrospective analysis of the isolation of Salmonella from pediatric fecal specimens in our hospital from 2015 to 2019 and the results of resistance to commonly used antibacterial drugs was conducted.Results A total of 169 strains of Salmonella were isolated from children’s feces from 2015 to 2019.The male to female ratio was 1.25:1.The children’s age range was skewed,mainly infants and young children<3 years,accounted for 80.5%(136/169).Seasonal distribution was dominated by autumn,followed by summer.81.7%(138/169)of children visited the clinic because of intestinal manifestations.A total of 22 serotypes were detected in 169 strains of Salmonella.Salmonella typhimurium had the highest isolation rate,51.5%(87/169),followed by Salmonella enteritidis 16.6%(28/169).The average resistance rates of Salmonella to ampicillin,trimethoprim/sulfamethoxazole,cefotaxime,ciprofloxacin,and chloramphenicol were respectively 85.8%,42.6%,18.3%,8.3%,and 39.1%.Resistance rates to ampicillin,trimethoprim/sulfamethoxazole and chloramphenicol were on the rise(P<0.05),and the resistance rate of ciprofloxacin showed a downward trend(P<0.05).No carbapenem resistant strains were isolated.Conclusion The isolation of Salmonella in children in our hospital was mainly from children under 3 years.Summer and autumn were disease-prone seasons.The most common serotype of the isolated Salmonella was Salmonella typhimurium.Meanwhile,the resistance to some antibacterial drugs has changed.The appropriate antibacterial drugs should be chosen clinically for treatment according to the actual situation.Relevant departments should strengthen the monitoring and prevention of Salmonella infection in children.