非伤寒沙门菌肠炎患儿临床症状及耐药性分析

Analysis of clinical symptoms and drug resistance of children with enteritis caused by non-typhoid salmonella

目的分析非伤寒沙门菌所致肠炎患儿的临床症状、血清型及耐药性。方法回顾性分析2018年1月至2020年12月本院确诊的56例非伤寒沙门菌肠炎患儿的临床资料,包括临床特征、血清分型、耐药性、治疗方法及预后效果。结果56例患儿年龄分布:4个月~1岁患儿占比最高,为53.57%;>2~7岁占比最低,为1.79%。56例患儿中46.43%存在并发症,主要包括肺炎、支气管炎、肠梗阻、中毒性脑病、低血糖等。感染非伤寒沙门菌类型:鼠伤寒沙门菌占比最高(46.43%),其次是肠炎沙门氏菌(41.07%);斯坦利沙门菌、猪霍乱沙门菌感染占比较低,分别为7.14%、5.36%。肠炎沙门氏菌、鼠伤寒沙门菌、斯坦利沙门菌、猪霍乱沙门菌对头孢哌酮钠舒巴坦钠、头孢曲松钠、美罗培南、头孢吡肟具有较高的敏感性,对头孢唑林钠、头孢呋辛钠、头孢西丁钠、氨苄西林、复方新诺明均具有较高的耐药性。56例患儿中,接受三代头孢治疗48例,接受哌拉西林钠他唑巴坦钠、酪酸梭菌肠球菌三联活菌片治疗8例,治疗痊愈率为100%。结论鼠伤寒沙门菌、肠炎沙门氏菌是导致非伤寒沙门菌感染性肠炎最主要的病原菌,患儿的主要症状为腹泻、发热,且对头孢哌酮钠舒巴坦钠、头孢曲松等药物具有较高的敏感性,对头孢唑林钠、头孢呋辛钠等具有较高的耐药性。

Objective To analyze the clinical symptoms,serotypes and drug resistance of children with enteritis caused by non-salmonella ty-phi.Methods The clinical data of 56 children with non-typhoid salmonella enteritis diagnosed in our hospital from January 2018 to December 2020 were analyzed retrospectively including clinical characteristics,serotypes,drug resistance,treatment methods and prognostic effects of the children.Results The age distribution of 56 children was as follows:4 months to 1 year old children accounted for the highest proportim 53.57%;>2~7 years old accounted for the lowest proportim 1.79%.46.43%of the 56 children had complications,including pneumonia,bronchitis,intestinal obstruc-tion,toxic encephalopathy,hypoglycemia,etc.Types of non-typhoid salmonella infection:Salmonella typhimurium accounted for the highest propor-tion(46.43%),followed by Salmonella enteritis(41.07%),the infection rate of Salmonella Stanley and Salmonella cholerae was 7.14%and 5.36%,re-spectively.Salmonella enteritidis,Salmonella typhimurium,Salmonella Stanley and Salmonella cholerae had high sensitivity to cefoperazone sodium sulbactam sodium,ceftriaxone sodium,meropenem and cefepime,and high resistance to cefazolin sodium,cefuroxime sodium,cefoxitin sodium,am-picillin and cotrimoxazole.Among the 56 children,48 cases received third-generation cephalosporin treatment,and 8 cases received piperacillin sodi-um tazobactam sodium and Clostridium caseinate enterococcus triplex viable tablets,and the recovery rate was 100%.Conclusion Salmonella ty-phimurium and Salmonella enteritis are the main pathogens causing non-typhoid salmonella enteritis.The main symptoms of children are diarrhea and fever,and they are highly sensitive to cefoperazone sodium,sulbactam sodium,ceftriaxone and other drugs,and have high resistance to cefazolin sodium and cefuroxime sodium.