儿童非伤寒沙门菌肠道感染的流行病学特点和药敏结果分析  

Characteristics of Epidemiology and Drug Susceptibility of Non-Typhoid Salmonellosis Infection in Children

作　　者：王红梅[1] 雷旻[1] 周高枫[1] 雷炎玲 谭锟 邓继岿[1] Wang Hongmei;Lei Min;Zhou Gaofeng;Lei Yanling;Tan Kun;Deng Jikui(Shenzhen Children’s Hospital,Guangdong Shenzhen 518038,China;The Zhuhai Campus of the Zunyi Medical College,Guangdong Zhuhai 519090,China)

机构地区：[1]深圳市儿童医院,广东深圳518038 [2]遵义医学院珠海校区,广东珠海519090

出　　处：《儿科药学杂志》2019年第2期37-40,共4页Journal of Pediatric Pharmacy

基　　金：深圳市科技研发资金;编号JCYJ20160429175723608;深圳市儿童医院重点专科资助项目;编号szetyy-zdzk-2015-gr

摘　　要：目的:了解本地区儿童非伤寒沙门菌肠道感染的流行病学特点,并监测其对抗菌药物的敏感性,探讨阿奇霉素治疗肠道非伤寒沙门菌感染的可能性,为进一步控制非伤寒沙门菌感染提供参考。方法:回顾性分析2014年7月至2016年6月深圳市儿童医院确诊并住院治疗的76例肠道非伤寒沙门菌感染患儿的年龄、性别、发病季节等流行病学特点;采用纸片扩散法检测5种常用抗菌药物的敏感性,采用E-Test法和纸片扩散法检测阿奇霉素的最低抑菌浓度(MIC),并对阿奇霉素的MIC值与其抑菌圈直径进行直线相关回归分析。结果:76株非伤寒沙门菌属于4种血清型,以鼠伤寒沙门菌血清型和肠炎沙门菌血清型为主; 1岁以下小婴儿54例,占71. 05%;非伤寒沙门菌对复方磺胺甲唑、头孢曲松、氯霉素、奈定酸、氨苄西林的敏感性分别为73. 68%、63. 16%、60. 53%、27. 63%和22. 37%;检出多重耐药非伤寒沙门菌16株,占21. 05%; E-Test法检测阿奇霉素对沙门菌的MIC为2～96μg/m L,MIC50为3μg/m L,MIC90为4μg/m L;纸片扩散法检测其抑菌圈直径范围为6. 50～19. 75 mm,二者显著相关(P<0. 01,r=-0. 836)。结论:本地区儿童肠道感染的非伤寒沙门菌血清型多样,以小婴儿为主,多重耐药菌比例较高;检出的非伤寒沙门菌对阿奇霉素的基础数据可以作为以后临床应用的参考指标。Objective: To investigate the epidemiological characteristics of non-typhoid Salmonellosis(NTS) infection in children in this region,monitor its sensitivity to antibiotics,and explore the possibility of azithromycin in the treatment of intestinal NTS infection,so as to provide scientific basis for further control of NTS infection. Methods: A retrospective analysis was made on the epidemiological characteristics in terms of the age,gender and onset season in 76 children with NTS infection in Shenzhen Children’s Hospital from July2014 to June 2016. The sensitivity of five commonly used antibiotics was detected by K-B method. The minimum inhibitory concentration(MIC) of azithromycin was detected by E-Test method and K-B method,and the MIC value of azithromycin and its inhibition zone diameter linear regression were analyzed. Results: The 76 strains of NTS belonged to 4 serotypes,and Salmonella typhimurium serotype and Salmonella enteritidis serotype were the main serotypes. Totally 54 infants were under 1 year old,accounting for 71. 05%. The sensitivity of NTS to compound trimoxazole,ceftriaxone,chloramphenicol,nalidixic acid and ampicillin were 73. 68%,63. 16%,60. 53%,27. 63% and 22. 37%,respectively. There were 16 strains of multi-drug resistant NSP,accounting for 21. 05%. MIC of azithromycin by using E-TEST was from 2 to 96 μg/m L,3 μg/m L for MIC50 and 4 μg/m L for MIC90. The diameter of the inhibition zone was determined by the disc diffusion method to be from 6. 50 to 19. 75 mm,which was significantly correlated(P<0. 01,r =-0. 836). Conclusion: NTS infection in children in this region are diverse,mainly in infants,with a high proportion of multi-drug resistance. The basic data of the detection of NTS against azithromycin can be used as a reference index for future clinical application.

关 键 词：伤寒沙门菌 流行病学 药物敏感性 阿奇霉素 

分 类 号：R725.7[医药卫生—儿科]