2017-2018年赣南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 in Gannan Area from 2017 to 2018

作　　者：谢美燕 廖晓卿 温婷 张杨 XIE Meiyan;LIAO Xiaoqing;WEN Ting;ZHANG Yang(Ganzhou Women and Children's Health Care Hospital,Jiangxi Province,Ganzhou 341000,China;不详)

机构地区：[1]江西省赣州市妇幼保健院,江西赣州341000

出　　处：《中国医学创新》2023年第27期166-170,共5页Medical Innovation of China

基　　金：赣州市卫生健康委员会科研计划项目(2022-2-107)。

摘　　要：目的:了解2017—2018年赣南地区儿童感染性腹泻沙门菌的血清型分布及耐药特点,为临床用药提供依据。方法:选取2017年1月—2018年12月赣州市妇幼保健院的感染性腹泻患儿共824例,分析大便培养为沙门菌的检出率及感染沙门菌的血清型分布和耐药特点。结果:在824例感染性腹泻患儿的粪便标本当中,共检出46株沙门菌,检出率为5.58%(46/824),2017年检出沙门菌21株,2018年为25株。2017年、2018年1~6岁均有最高的检出率,但与<1岁、7~14岁相比,差异均无统计学意义(P>0.05)。沙门菌分布存在明显的季节性差异,均以夏季、秋季为主,且均高于同年春季、冬季(P<0.05)。可将检出沙门菌划分成11个血清型,主要有鼠伤寒沙门菌(43.48%)、肠炎沙门菌(15.22%)、德尔卑沙门菌(10.87%)等。针对各个血清型而言,其有着相似的耐药性,对常用抗生素氨苄西林的耐药性最高,复方磺胺甲恶唑居其次;而对酶抑制剂、第三代头孢菌素、氟喹诺酮类药物耐药性较低。结论:2017—2018年赣南地区的儿童感染性腹泻沙门菌主要血清型为鼠伤寒沙门菌、肠炎沙门菌和德尔卑沙门菌,对磺胺类、氨苄西林有着较高的耐药性,存在严重的多重耐药情况,针对沙门菌感染的腹泻用药时应根据药敏试验合理选择抗生素。Objective:To understand the serotype distribution and drug resistance characteristics of Salmonella in children with infectious diarrhea in Gannan area from 2017 to 2018,and to provide basis for clinical medication.Method:A total of 824 children with infectious diarrhea admitted to Ganzhou Women and Children's Health Care Hospital from January 2017 to December 2018 were selected to analyze the detection rate of Salmonella in stool culture and the serotype distribution and drug resistance characteristics of Salmonella infection.Result:Among the fecal samples of 824 children with infectious diarrhea,a total of 46 strains of Salmonella were detected,with a detection rate of 5.58%(46/824).In 2017,21 strains of Salmonella were detected,and in 2018,25 strains were detected.In 2017 and 2018,the 1~6 years old group had the highest detection rate,but there was no significant difference compared with the<1 year old group and the 7-14 years old group(P>0.05).There were obvious seasonal differences in the distribution of Salmonella,mainly in summer and autumn,and higher than those in spring and winter in the same year(P<0.05).The detected Salmonella could be divided into 11 serotypes,mainly including Salmonella typhimurium(43.48%),Salmonella enteritidis(15.22%),and Salmonella derby(10.87%)and so on.For each serotype,they had similar drug resistance,with the highest drug resistance to the commonly used antibiotic Ampicillin,followed by compound Sulfamethoxazole.However,resistance to enzyme inhibitors,third-generation cephalosporins,and fluoroquinolones was relatively low.Conclusion:From 2017 to 2018,the main serotypes of Salmonella in children with infectious diarrhea in Gannan area are Salmonella typhimurium,Salmonella enteritidis and Salmonella derby,which have a high resistance to Sulfonamides and Ampicillin,and there is a serious situation of multiple drug resistance.Antibiotics should be selected reasonably according to drug sensitivity test for diarrhea caused by Salmonella infection.

关 键 词：赣南地区 急性胃肠炎 沙门菌感染 血清型 耐药性 

分 类 号：R725[医药卫生—儿科] R446.5[医药卫生—临床医学]