Salmonella osteomyelitis of the thoracic spine: an unusual presentation

A case of thoracic vertebral osteomyelitis due to Salmonella enteritidis phage type 2 in an immunocompetent patient is reported. The patient initially presented with abdominal, urinary and chest symptoms, which were followed by a large pleural effusion. The infection was successfully treated with ciprofloxacin. This is the only case of salmonella thoracic vertebral osteomyelitis in an immunocompetent patient reported in the English literature.     

甲型副伤寒沙门菌48例临床分析

目的探讨甲型副伤寒沙门菌的临床特点,以提高诊治水平。方法回顾性分析我科甲型副伤寒住院病例的药敏试验结果及临床特点,并与近年伤寒病例做对比。结果甲型副伤寒组消化道症状较伤寒组明显,更易并发肝脏损害,甲型副伤寒沙门菌对喹诺酮类,亚胺培南,三代头孢菌素敏感性好。结论甲型副伤寒早期临床症状不典型,易误诊,对临床常用抗生素的敏感性好。     

儿童沙门氏菌感染性腹泻的血清学及临床特征分析

目的 了解沙门氏菌导致的儿童感染性腹泻病的临床特征,分析沙门氏菌的血清型分布及耐药情况,为临床合理的治疗提供依据.方法 收集2015年1月至2017年7月我院肠道门诊接诊治疗的腹泻病患儿中粪便沙门氏菌阳性的病例,进行临床特征分析和病原体血清学分析.结果 共收集粪便标本2 180份,培养分离得到沙门氏菌株196株(8.99％).男111例(56.6％),女85例(43.4％),男女之比为1.3∶1;年龄最小21d,最大12岁,年龄越小病例数越多.血清型主要为鼠伤寒沙门氏菌79株(40.3％),肠炎沙门氏菌55株(28.1％);鼠伤寒沙门氏菌在0～1岁年龄组的检出率(65.8％)明显高于肠炎沙门氏菌(32.7％);而其他各年龄组的肠炎沙门氏菌的检出率要高于鼠伤寒沙门氏菌.沙门氏菌对氨苄西林耐药性较高,为81.12％,对头孢曲松的耐药率平均为23.46％;对氯霉素、环丙沙星和复方新诺明的耐药率＜10％.临床表现中0～1岁患儿的粪便呈稀糊状的占81.1％.平均发热天数随着年龄增大而减少,差异有统计学意义(P=0.043).对大便培养随访复查发现,排菌＞5周的患儿占25.5％,＜3岁者占大多数,差异有统计学意义(P=0.045).0～1岁组迁延性腹泻的发生率明显高于其他组,差异有统计学意义(P=0.011).结论 沙门氏菌在不同年龄组患儿中临床表现和血清型特征不同,应合理选用抗生素治疗及正确看待长期带菌情况,通过合理的卫生措施减少对沙门氏菌的暴露感染.     

Uncomplicated falciparum malaria complicated by salmonella septicaemia: cause not coincidence

A male patient of 10-year-old presented with fever, headache and vomiting for last few days. He was being treated with antimalarial drugs. On 14th day of illness he again showed rise of temperature. His blood culture showed growth of Salmonella typhi. He was treated with ceftriaxone and responded favourably. Here uncomplicated falciparum malaria developed a secondary infection with salmonella during hospital stay. This uncommon association was noted rather than a mere coincidence, which rarely reported in literature.     

Scalp abscess due to Salmonella typhimurium-- a case report

The incidence of non-typhoidal salmonellosis has markedly increased in the past decade. Localised infection develops in approximately 5-10% of persons with salmonella bacteraemia. In this report, a 4-year-old female child suffering from acute lymphoid leukaemia is presented with high grade intermittent fever. Pustular lesions were observed over the right side of the scalp. The scalp abscess was drained and pus was sent for culture and sensitivity. Culture grew Salmonella typhimurium. Blood culture also grew the same organism. She had an uneventful recovery after treatment.     

Enzyme replacement therapy in the management of longstanding skeletal and soft tissue salmonella infection in a patient with Gaucher's disease

A splenectomised patient with Gaucher's disease who developed multiple foci of osteomyelitis and soft tissue abcesses, after a severe episode of group C salmonella sepsis, is described. Aggressive antibiotic treatment and surgical drainage had little effect and the patient's condition continued to deteriorate. With initiation of enzyme replacement therapy (ERT) in addition to specific antibiotic treatment, defervescence and gradual healing occurred. Complete resolution of the infection was seen after 15 months. The possible role of ERT in healing bacterial infections in Gaucher's disease is discussed.     

Ciprofloxacin-resistant Salmonella enterica serotype typhi in a patient with osteomyelitis of the rib

Salmonella osteomyelitis of the rib is a rare clinical entity. In our case, a muhidrug resistant Salmonella enterica serotype Typhi was isolated from an immuno-competent patient with osteomyclitis of the ribs, who was treated earlier with ciprotloxacin for typhoid fever. The patient was successfully treated for osteomyclitis with intravenous ceftriaxone.     

Campylobacter as a cause of acute enteritis in children in South Australia. II. Clinical comparison with salmonella, rotavirus and non-specific enteritis

The clinical features of 17 children with campylobacter enteritis were compared with 17 age- and sex-matched children with enteritis due to salmonella, rotavirus or those in whom there was no identifiable pathogen. Prominent clinical features of campylobacter enteritis included fever, diarrhoea, vomiting, blood in stools and periumbilical pain. Dehydration was uncommon, compared to rotavirus and non-specific enteritis. The acute illness was self-limited, in spite of prolonged asymptomatic faecal excretion of the organism. This prolonged carriage increases the risk of cross infection. No patient with campylobacter required antibiotic therapy. Recurrent epidoses of diarrhoea were seen in three children but on no occasion was campylobacter the cause. This study has demonstrated a marked similarity between campylobacter and salmonella enteritis, making clinical distinction virtually impossible. Bloody diarrhoea, a feature of bacterial infections, was absent in rotavirus and non-specific enteritis.     

丽水地区艾滋病患者血流感染沙门菌的血清型分布及耐药性分析

目的分析丽水地区艾滋病患者感染沙门菌的血清型分布和耐药性。方法按国家标准和NCCLS推荐的K-B法对艾滋病标本和体检标本检出的沙门菌进行血清分型和耐药性检测。结果两组标本中检出的沙门菌的菌型分布以B群、C群和D群为主,病人标本检出伤寒沙门菌112株(36.84%),肠炎沙门菌84株(27.63%),德尔卑沙门菌27株(8.88%),其他为阿贡那沙门菌、乙型副伤寒沙门菌、鼠伤寒沙门菌等,体检标本检出沙门菌血清型比较多的是伤寒沙门菌26株(31.71%),肠炎沙门菌17株(20.73%),阿贡那沙门菌6株(7.32%)。药敏试验显示沙门菌敏感性最好的抗生素为氨曲南,对氨苄西林、复方新诺明、左氧氟沙星、环丙沙星、氯霉素的耐药趋势增高,多重耐药比较严重。结论临床医师在选择治疗药物时应参考本地区的菌群、耐药性变化的监测结果,合理正确使用抗菌药物。     

Multiorgan involvement due to Salmonella typhi: case report

A 12-year-old male presented with osteomyelitis and poliarthritis; after hospitalisation he developed subcutaneous abscesses, endocarditis and pericarditis. The diagnosis of typhoid fever was made when blood cultures grew Salmonella typhi. The patient was cured with a regimen of ceftriaxone and ciprofloxacin.     

Salmonellosis and ulcerative colitis. A causal relationship or just a coincidence

Coincidence of salmonellosis and ulcerative colitis is a rare clinical problem. Salmonella infection was reported to complicate the ulcerative colitis, as either facilitating its occurrence or activation. In this article, we present a case with salmonellosis whose clinicopathological findings also suggested ulcerative colitis. The patient improved rapidly after taking additional mesalazine to norfloxacin treatment. We conclude that salmonella infection might have either been coincidentally present or might have triggered an early ulcerative colitis in this patient who did not have history of inflammatory bowel diseases. In case of persistent severe diarrhea despite appropriate treatment, the possibility of a coincident inflammatory bowel disease such as ulcerative colitis should always be considered, especially in endemic regions for salmonellosis.     

脉冲场凝胶电泳在沙门菌鉴定中的应用

目的 探讨脉冲场凝胶电泳(PFGE)在沙门菌分型鉴定中的应用价值.方法 用PFGE方法对一起食物中毒分离出的68株肠炎沙门菌菌株进行分子分型.结果 180份标本经传统生化和血清分型鉴定出的68株肠炎沙门菌,通过PFGE分型后,均产生14条电泳条带,且分子量大小一致.通过BioNumerics软件的数据化处理分析,得到聚...     

2016—2018年广州地区儿童非伤寒沙门菌感染的临床流行病学特征

目的 了解广州地区儿童非伤寒沙门菌感染的流行病学特征及临床特点,为本地区非伤寒沙门菌感染的预防和治疗提供借鉴。方法以2016年1月至2018年12月广州市第一人民医院及南沙中心医院分院腹泻患儿为研究对象,纳入研究的患儿均留取粪便进行细菌培养,记录就诊患儿的流行病学资料、人口学信息以及大便培养结果,对收集资料进行统计分析。结果2016—2018年共纳入2 658例,收集其大便标本进行大便细菌培养,共有258例粪便细菌培养沙门菌阳性,分离率为9.7%（258/2 658）;其中,4例为伤寒沙门菌,伤寒沙门菌分离率为0.2%（4/2 658）;非伤寒沙门菌254例,分离率为9.5%（254/2 658）。2016—2018年男女患病数为：男1 466例,女1 192例,男性大便分离阳性率为10.2%,女性大便分离阳性率为9.1%,两者差异无统计学意义（2=1.083,P=0.298）。2016—2018年各年龄组患儿沙门菌阳性率为2.5%～14.7%,以1～2岁年龄段阳性率最高,各年龄组间差异有统计学意义（2=7.52,P=0.000）。沙门菌阳性患儿不同年龄组的占比如下：<1岁为42.2%（109/258）;1～2岁为36.4%（94/258）;2～3岁为10.9%（28/258）;3～4岁5.0%（13/258）;4～5岁为0.8%（2/258）;5～10岁为3.1%（8/258）;10～18岁为1.6%（4/258）;其中,3岁以下患儿占比达89.5%。2016—2018年,各月份沙门菌分离阳性率在0.79%～14.45%之间,组间差异有统计学意义（F=5.719,P=0.000）。其中,1、2、3、12月分离阳性率较低（0.79%～2.1%）,4~11月份分离阳性率（9.51%～14.45%）明显高于其他月份,且差异有统计学意义（P<0.01）。结论2016—2018年沙门菌感染性腹泻患儿中,以非伤寒沙门菌感染为主,伤寒沙门菌感染以散发出现。非伤寒沙门菌感染全年均可发病,高发季节为春夏秋三季,好发于3岁以下婴幼儿。     

Two-staged revision total hip arthroplasty due to Salmonella infection: case report

Salmonella infection of a hip prosthesis has rarely been reported, and only a few cases have been documented. It is painful, disabling, costly, and may be associated with life-threatening sepsis even in a healthy individual. Removal of the implant is often required to eradicate the infection. Several early studies reported procedures to control the salmonella infection, but none described reconstruction of the destroyed hip joint. We present a case of salmonella sepsis 4 years after a total hip arthroplasty (THA). After prosthesis removal, radical debridement of the infected tissues, and administration of Imipenum (500 mg, 4 times daily), the systemic sepsis and hip infection were ameliorated. Four months later, a 2-stage revision THA was done for reconstruction of the hip joint. The clinical results 51 months following the THA procedure were satisfactory without an infectious reaction.     

Acute acalculous cholecystitis: a rare complication of typhoid fever

Acute acalculous cholecystitis is a very rare complication of typhoid fever, and may be due to multi-drug resistant and virulent forms of Salmonella infection. It is particularly rare in adults. A 21-year-old woman, presenting with fever, vomiting, diarrhoea and abdominal pain, was found to have acute acalculous cholecystitis due to typhoid fever on basis of ultrasonographical findings and a positive Widal's test for Salmonella typhi. She was treated with antibiotics and made a full recovery.     

小鼠STM多种感染模型中肿瘤坏死因子-alpha的肠道及肠外器官表达

目的研究小鼠在菌群失调或免疫抑制状态下,感染STM时,TNF-alpha在肠道和肠外器官的表达情况。方法分别用氢化可的松腹腔注射小鼠后再接种STM,用链霉素灌胃后接种STM,用STM直接灌胃小鼠,以及用生理盐水灌胃小鼠,然后使用免疫组织化学和图像分析半定量测定各自肠道和肠外器官的TNF-alpha各时点表达情况,统计分析各组TNF-alpha表达差异。结果接种了STM的各组小鼠的小肠、回盲部及其他脏器TNF-alpha表达阳性,对照组未出现上述变化。TNF-alpha表达阳性的3组小鼠随时间变化的小肠、回盲部TNF-alpha表达曲线趋势有差异,经单变量多因素方差分析统计检验,P<0.05。结论使用糖皮质激素所造成的免疫抑制后用STM感染小鼠,能抑制肠道TNF-alpha的表达;而使用抗生素后用STM感染小鼠,能增强肠道TNF-alpha的表达。     

Pott's disease in heroin addicts.

Five cases of tuberculous vertebral osteomyelitis occurred in heroin addicts at St Luke's Hospital Center between 1955 and 1975. All patients were men, and four were between 19 and 33 years of age. In contrast with the indolent onset typical to pyogenic or fungal vertebral osteomyelitis in heroin addicts, patients with Pott's disease had an acute toxic reaction, with fever, back pain, weight loss, and night sweats. Neurologic abnormalities, uncommon with pyogenic or fungal vertebral infection, occurred in all patients with tuberculous involvement of the spine. Roentgenograms of the spine were atypical in four patients, including two with an "ivory vertebra." All patients had involvement of extravertebral sites, and one patient had infection with Mycobacterium tuberculosis and M avium.     

云南省鼠伤寒沙门氏菌PFGE分子分型及耐药情况

目的 了解云南省鼠伤寒沙门氏菌PFGE分子分型及耐药状况, 为防控由鼠伤寒沙门氏菌引起的疾病提供科学依据.方法 根据Pulse Net China公布的沙门氏菌PFGE分型技术进行分子分型.分析得出药敏板MIC值, 根据CLSI的相应标准获得出S、I、R结果.结果 云南省68株鼠伤寒沙门氏菌呈53种PFGE带型.68株鼠伤寒沙门氏菌对复合磺胺 (SXT) 的耐药率最高, 为45.59%, 对亚胺培南 (IMP) 最敏感.其中1株菌对14种抗生素中11种抗生素耐药.结论 云南省鼠伤寒沙门氏菌分子分型呈多样性.复方磺胺是云南地区鼠伤寒沙门氏菌最耐药抗菌素.地区鼠伤寒沙门氏菌多重耐药不典型.     

武汉社区腹泻病人粪便中致病菌的构成与耐药性研究

目的了解夏秋季武汉社区引起腹泻病原菌的流行性及耐药状况。方法收集2004年7月1日至10月31日武汉社区4所大型医院4536份门诊腹泻病人粪便标本进行鉴定及药敏试验;REP-PCR对主要致病菌进行基因分型。结果4536份粪便标本中,分离出非伤寒沙门菌64株（1.4%）,志贺菌29株（0.6%）,致病性大肠杆菌33株（0.7%）。其中主要致病菌是鼠伤寒沙门菌33株（52%）,D群志贺菌16株（55%）。挑选13种抗菌药物进行体外敏感试验,并将分离的致病菌对这13种抗生素的耐药率﹑敏感率﹑中介率进行比较,其中非伤寒沙门菌对喹诺酮类的耐药率较其他两种要高,但对第三代头孢的敏感性较强。分离的3种致病菌在第三代头孢抗生素的作用中对头孢他啶的敏感性最强。32株鼠伤寒沙门菌基因分型为9种,16株D群志贺菌基因分型为7种。结论武汉社区内感染性腹泻的致病菌主要以非伤寒沙门菌﹑致病性大肠杆菌和志贺菌为主,其中非伤寒沙门菌占了51%,基因分型提示有社区流行趋势,而且这些致病菌对肠道杆菌常用抗生素的耐药性较为严重。本次调查结果对该社区临床用药起到一定的提示作用。     

无锡市锡山区首次检出1株伦敦沙门菌的报告

目的了解无锡市锡山区外环境监测样品中沙门菌的污染状况。方法采集外环境监测标本进行沙门菌分离培养,依照《食品安全国家标准食品微生物学业检验沙门菌检验》GB4789.4-2010进行目的菌的分离检测;并对分离株进行生化反应、血清学试验及药敏试验。结果从1份市售生螺蛳中检出1株伦敦沙门菌。结论沙门菌广泛存在自然界,开展沙门菌监测,及早检出和发现沙门菌属新菌型,对该菌引发的疾病和公共卫生事件的防控有着重要的指导意义。