儿童非伤寒沙门菌肠炎的耐药性及无症状带菌情况分析

Drug Resistance and Asymptomatic Carriage in Children with Non-Typhoid Salmonella Infection

目的:分析儿童非伤寒沙门菌肠炎的临床特征、耐药性及恢复期无症状带菌情况,为合理使用抗菌药物提供参考。方法:回顾性收集粪培养结果为非伤寒沙门菌的患儿病例资料,按出院时粪培养是否检出非伤寒沙门菌将入组患儿分为转阴组和未转阴组,分析两组患儿的临床特征、血清型分布、耐药性及恢复期带菌情况。结果:120株非伤寒沙门菌中,鼠伤寒血清型(76株,63.3%)最多。转阴组和未转阴组对抗菌药物的耐药率比较差异无统计学意义(P>0.05)。120例患儿中,76例(63.3%)感染多重耐药非伤寒沙门菌,经抗感染治疗临床症状治愈但粪培养未转阴者占62.5%。结论:本地区儿童非伤寒沙门菌多重耐药菌株比例较高,应加强监测并规范抗菌药物使用。恢复期无症状带菌是非伤寒沙门菌感染的常见后遗症,应规范抗菌药物使用疗程,以免延长带菌周期或诱导细菌耐药。

Objective:To study the clinical characteristics,drug resistance and asymptomatic carriage of non-typhoid Salmonel enteritis in children,so as to provide reference for rational use of antibiotics.Methods:General clinical data of children with non-typhoid Salmonella in fecal culture were retrospectively collected.According to the detection of non-typhoid Salmonella in stool culture at discharge,the enrolled children were divided into the negative group and positive group.Clinical characteristics,serotype distribution,drug resistance and asymptomatic carriage in two groups were analyzed.Results:Among the 120 non-typhoid Salmonella strains,Salmonella typhimurium serotype(76 strains,63.3%)took the lead.There was no statistically significant difference in antimicrobial resistance between the negative group and positive group(P>0.05).Among the 120 children,76 cases(63.3%)were infected with multi-resistant non-typhoid Salmonella,and 62.5%were asymptomatic carriers after anti-infective treatment.Conclusion:The proportion of multi-drug resistant strains of non-typhoid Salmonella in children in this region is high,the monitoring and use of antibiotics should be strengthened.Asymptomatic carriage during recovery is a common sequel to non-typhoidal Salmonella infection,and the course of antimicrobial use should be standardized to avoid prolonging the carriage cycle or inducing bacterial resistance.