2021~2023年广西南宁地区儿童感染性腹泻沙门菌血清型及耐药性分析

Analysis of serotypes and drug resistance of Salmonella in children with infectious diarrhea from 2021 to 2023 in Nanning,Guangxi

目的探讨2021~2023年广西南宁地区儿童感染性腹泻沙门菌血清型及耐药性。方法选取2021~2023年广西南宁地区3618例沙门菌感染性腹泻患儿标本,对其进行细菌培养与耐药性分析,评估沙门菌感染性腹泻患儿血清型分布、季节分布、年龄分布以及耐药性情况。结果3618株沙门菌中,鼠伤寒沙门菌血清型占比最多(46.63%),其次为无血清型(26.42%),其余依次为其他B群沙门菌(13.24%)、D群(7.63%)、C1群(6.08%)。3618株沙门菌中,8月感染检出率最高(14.37%),其余依次为10月(14.23%)、7月(13.96%)、9月(12.22%)、6月(12.02%)、11月(8.07%)、5月(7.63%)、4月(5.42%)、12月(4.39%)、3月(3.07%)、1月(2.87%)、2月(1.74%);第三季度感染检出率最高(40.55%),其余依次为第四季度(26.70%)、第二季度(25.07%)、第一季度(7.68%)。3618例沙门菌感染性腹泻患儿中,2999例年龄为7个月~3岁,占比最高(82.89%),其余依次为0~6个月(12.00%)、4~6岁(2.82%)、7~14(2.29%)。沙门菌药敏试验结果显示,沙门菌敏感率前三位药物为美罗培南(99.81%)、亚胺培南(99.78%)、哌拉西林/他唑巴坦(98.12%),敏感率后三位药物依次为氨苄西林(29.02%)、左氧氟沙星(39.86%)、氨苄西林/舒巴坦(40.66%);耐药率前三位药物依次为氨苄西林(70.87%)、复方新诺明(48.42%)、氯霉素(45.36%),耐药率后三位药物分别为美罗培南(0.14%)、亚胺培南(0.17%)、哌拉西林/他唑巴坦(0.97%)。结论2021~2023年广西南宁地区沙门菌感染性腹泻患儿多为鼠伤寒沙门菌血清型,多发生于7个月~3岁儿童,第三季度高发,第一季度少发。本研究检测出的3618株沙门菌对美罗培南、亚胺培南、哌拉西林/他唑巴坦具有较高的敏感性与较低的耐药性,临床可根据药敏试验结果合理用药,减少抗生素滥用的发生。

Objective To explore the serotype and drug resistance of Salmonella in children with infectious diarrhea in Nanning,Guangxi from 2021 to 2023.Methods A total of 3618 specimens of children with diarrhea infected by Salmonella from Nanning,Guangxi from 2021 to 2023 were selected for bacteria culture and drug resistance analysis.The serotype distribution,seasonal distribution,age distribution and drug resistance of children with diarrhea infected by Salmonella were evaluated.Results Among the 3618 strains of Salmonella,the serotype of Salmonella typhimurium accounted for the most(46.63%),followed by non-serotype(26.42%),and the other serotypes were other group B Salmonella(13.24%),group D(7.63%),and Group C1(6.08%).Among the 3618 Salmonella strains,the highest detected month was August(14.37%),followed by October(14.23%),July(13.96%),September(12.22%),June(12.02%),November(8.07%),May(7.63%),April(5.42%),December(4.39%),March(3.07%),January(2.87%),February(1.74%).The highest detection rate was found in the third quarter(40.55%),followed by the fourth quarter(26.70%),the second quarter(25.07%)and the first quarter(7.68%).Among 3618 cases of Salmonella diarrhea,2999 cases aged were 7 months to 3 years old,accounting for the highest proportion(82.89%),followed by 0 to 6 months(12.00%),4 to 6 years old(2.82%)and 7 to 14 years old(2.29%).The results of Salmonella drug sensitivity test showed that the top three drugs with the highest sensitivity rate of Salmonella were meropenem(99.81%),imipenem(99.78%)and piperacillin/tazobactam(98.12%).The top three drugs with the lowest sensitivity were ampicillin(29.02%),levofloxacin(39.86%)and ampicillin/sulbactam(40.66%).The top three drug with the highest resistance rates were ampicillin(70.87%),co-trimoxazole(48.42%)and chloramphenicol(45.36%).The top three drugs with the lowest resistance rates were meropenem(0.14%),imipenem(0.17%)and piperacillin/tazobactam(0.97%).Conclusion From 2021 to 2023,Salmonella serotypes in children with infectious diarrhea in Nanning,Guangxi were mostly Salmonella typhimurium serotypes,mostly occur in children aged 7 months to 3 years old,with a high incidence in the third quarter and a low incidence in the first quarter.The 3618 strains of Salmonella detected in this study showed high sensitivity and low resistance to meropenem,imipenem and piperacillin/tazobactam.Clinically,rational medication can be used based on drug sensitivity results to reduce the occurrence of antibiotic abuse.