儿童肠道感染鼠伤寒沙门菌的临床特征及耐药性分析

Clinical characteristics and drug resistance analysis of Salmonella typhimurium in children with intestinal infection

目的:探讨儿童肠道感染鼠伤寒沙门菌的临床特征以及耐药情况,为临床合理使用抗生素提供理论依据。方法:收集2019—2021年汕头市中心医院肠道感染鼠伤寒沙门菌患儿224例,回顾性分析其临床特征及耐药情况。结果:224例鼠伤寒沙门菌肠炎患儿中2岁以下患儿212例(94.64%),感染人数逐年增加(χ^(2)=448.0,P<0.05),发病高峰期在夏秋季(72.32%)。209例(93.30%)出现发热,207例(92.42%)出现腹泻,大便次数5次以上160例(71.43%)。224株鼠伤寒沙门菌对碳青霉烯类抗生素(亚胺培南、厄他培南)的敏感率100%,对哌拉西林/他唑巴坦敏感率96.43%,对三代头孢的敏感率由高到低依次为头孢哌酮/舒巴坦(92.86%)、头孢他啶(84.82%)和头孢曲松(78.13%),四代头孢吡肟敏感率为86.16%。结论:鼠伤寒沙门菌肠炎好发于2岁以下婴幼儿,发病率呈逐年上升趋势,大部分患儿可出现发热、腹泻、大便次数增多等症状,应合理使用抗生素,减少耐药菌株的产生。

Objective:To investigate the clinical characteristics and drug resistance of Salmonella typhimurium in children with intestinal infection,and to provide a theoretical basis for the rational use of antibiotics in clinical practice.Methods:A total of 224 children with intestinal infection of Salmonella typhimurium in Shantou Central Hospital from 2019 to 2021 were collected,and their clinical characteristics and drug resistance were retrospectively analyzed.Results:Among the 224 children with Salmonella typhimurium enteritis,212(94.64%)were under 2 years old.The number of infected children increased year by year(χ^(2)=448.0,P<0.05).The peak incidence was in summer and autumn(72.32%).Fever occurred in 209 cases(93.30%),diarrhea in 207 cases(92.42%),and stool frequency of more than 5 times in 160 cases(71.43%).224 strains of Salmonella typhimurium were 100%sensitive to carbapenems(imipenem,ertapenem),96.43%sensitive to piperacillin/tazobactam,and sensitive to third-generation cephalosporins were cefoperazone/sulbactam(92.86%),ceftazidime(84.82%)and ceftriaxone(78.13%),and the sensitivity rate of fourth-generation cefepime was 86.16%.Conclusion:Salmonella typhimurium enteritis occurs in infants and young children under 2 years old,and the incidence rate is increasing year by year.Most of the children may have symptoms such as fever,diarrhea,and increased stool frequency.Antibiotics should be used rationally to reduce the production of drug-resistant strains.