120例鼠伤寒沙门菌感染患儿的临床特征及耐药模式分析  

Clinical characteristics and drug resistance of Salmonella typhimurium infection in children in Dazhou

作　　者：张燕娓 程阔菊[2] ZHANG Yanwei;CHENG Kuoju(Department of Pediatrics,Dazhou Hospital of Integrated Traditional Chinese and Western Medicine,Dazhou,Sichuan 635000,China;Department of Clinical Pharmacy,Dazhou Hospital of Integrated Traditional Chinese and Western Medicine,Dazhou,Sichuan 635000,China)

机构地区：[1]达州市中西医结合医院儿科,四川达州635000 [2]达州市中西医结合医院临床药学室,四川达州635000

出　　处：《热带医学杂志》2025年第1期90-93,98,共5页Journal of Tropical Medicine

基　　金：四川省中医药管理局项目(2023MS275)。

摘　　要：目的了解鼠伤寒沙门菌感染患儿的临床特征及耐药模式,为鼠伤寒沙门菌感染的临床防治提供参考依据。方法选取2021年1月-2023年12月在达州市中西医结合医院肠道门诊就诊的120例鼠伤寒沙门菌感染患儿,进行肠道细菌分离鉴定和临床特征分析,采用K-B纸片扩散法行药敏性分析。结果120例鼠伤寒沙门菌感染患儿中,2021-2023年分别为49例(40.83%)、39例(32.50%)、32例(26.27%);男性占61.67%(74/120),年龄以<1岁患儿为主(33.33%),70.83%(85/120)为散居儿童;93.33%(112/120)患儿入院时伴高热,90.83%(109/120)大便有黏液、血,40.00%(48/120)患儿有呕吐症状;大便常规显示白细胞异常、红细胞异常、脓细胞、白细胞计数增高、C反应蛋白增高分别占95.00%(114/120)、87.60%(106/120)、58.20%(71/120)、61.79%(76/120)、64.52%(80/120)。120例鼠伤寒沙门菌感染患儿的性别、年龄及职业分布差异均有统计学意义(χ^(2)=13.067、48.360、115.425,P均<0.05),但不同年间鼠伤寒沙门菌感染患儿的性别、年龄及职业分布差异无统计学意义(χ^(2)=0.014、0.582、3.716,P均>0.05)。耐药模式上,儿童鼠伤寒沙门菌感染对四环素、氨苄西林、氯霉素耐药率分别为81.67%(98/120)、79.17%(95/120)、51.67%(62/120);对头孢曲松、头孢他啶、头孢哌酮舒巴坦耐药率相对较低,分别为0.83%(1/120)、1.67%(2/120)、4.17%(5/120);ACSSuT耐药表型、ACSSu TAuCx耐药表型、≥3种耐药率分别为35.83%(43/120)、2.50%(3/120)、29.17%(35/120)。结论医院儿童鼠伤寒沙门菌感染呈逐年下降趋势,以男性、年龄<1岁、散居儿童为高发群体,对头孢曲松、头孢他啶、头孢哌酮舒巴坦敏感,值得临床重视。Objective The aim of this study was to understand the clinical characteristics and drug resistance of Salmonella typhimurium infection in children.Methods A total of 120 children with Salmonella typhimurium infection who visited the Department of intestinal Outpatient at the Dazhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to December 2023 were analyzed retrospectively.Intestinal bacterial isolation and identification and clinical feature analysis were conducted.K-B disk diffusion method was used for antibiotic sensitivity analysis.Results Among 120 children with Salmonella typhimurium infection,there were 49(40.83%)cases in 2021,39(32.50%)cases in 2022,and 32(26.27%)cases in 2023.Boys accounted for 61.67%(74/120);most of the children were under 1 year old(33.33%),and 70.83%(85/120)were scattered children.93.33%(112/120)of the children had high fever upon admission,90.83%(109/120)had mucus and blood in their stools,and 40.00%(48/120)had vomiting symptoms.Routine stool examination showed abnormalities in white blood cells,red blood cells,pus cells,increased white blood cell count,and elevated C-reactive protein,accounting for 95.00%(114/120),87.60%(106/120),58.20%(71/120),61.79%(76/120),and 64.52%(80/120),respectively.There were statistically significant differences in gender,age,and occupational distribution among 120 children infected with Salmonella typhimurium(χ^(2)=13.067,48.360,115.425;all P<0.05),but there were no statistically significant differences in gender,age,and occupational distribution among children infected with Salmonella typhimurium in different years(χ^(2)=0.014,0.582,3.716;all P>0.05).In terms of drug resistance patterns,the resistance rates of children infected with Salmonella typhimurium to tetracycline,ampicillin,and chloramphenicol were 81.67%(98/120),79.17%(95/120),and 51.67%(62/120),respectively.The resistance rates to ceftriaxone,ceftazidime,and cefoperazone sulbactam were relatively low,which were 0.83%(1/120),1.67%(2/120),and 4.17%(5/120),res

关 键 词：鼠伤寒沙门菌 儿童 头孢曲松 头孢他啶 头孢哌酮舒巴坦 

分 类 号：R378.22[医药卫生—病原生物学]