296例腹泻患儿非伤寒沙门菌菌型分布及药敏分析

目的 了解2013至2015年广州地区腹泻患儿非伤寒沙门菌感染的流行病学特征和耐药情况.方法 对2013至2015广东省妇幼保健院门诊及住院的腹泻患儿的粪便标本进行沙门菌培养和血清学分型,采用VITEK-2 Compact进行药物敏感性试验.结果 296株非伤寒沙门菌可分为33种血清型,其中鼠伤寒沙门菌171株(占57.43％),斯坦利沙门菌29株(占9.80％),肠炎沙门菌18株(占6.08％).患儿男女性别比约为1.51∶1(178/118),＜1岁的患儿占84.45％,每年的7～ 10月为发病高峰.296株沙门菌除了对碳青霉烯类、左氧氟沙星和三代头孢耐药率较低外,对一、二代头孢、庆大霉素、妥布霉素和复方磺胺甲恶唑耐药较为严重.鼠伤寒沙门菌对三代头孢的耐药率呈现逐年上升的趋势.结论 广州地区儿童非伤寒沙门菌感染性腹泻以＜1岁的婴幼儿居多,夏秋季节高发.鼠伤寒沙门菌是本地区最主要的菌型,也是耐药最严重的血清型.临床应根据药敏试验结果合理选用抗生素.

Serotype distribution and antimicrobial susceptibility of non-typhoid salmonella in 296 children with infectious diarrhea

Objective To investigate the epidemiological characteristics and drug resistance of non-typhoid salmonella (NTS) infection in children in Guangzhou from 2013 to 2015.Methods Salmonella was cultured using the stool samples collected from the diarrheal children,in-or out-patients at Guangdong Women and Children Hospital.The isolates were identified by serological typing.Antimicrobial susceptibility was tested by VITEK-2 Compact automicroscan.Results The 296 strains of NTS could be divided into 33 serotypes.Among which,171 (57.43％) strains were salmonella typhimurium,29 (9.80％) salmonella stanley,and 18 (6.08％) salmonella enteritidis.The male-to-female ratio for children with infectious diarrhea was 1.51∶1.The NTS infection peak was from July to October.84.45％ infants were less than 1 year old.Susceptibility test indicated that the 296 strains of NST were severely resistant to the first and second generations of cephalosporin,gentamicin,tobramycin,and trimethoprim-sulfamethoxazole,while susceptible to carbapenem,levofloxacin,and the third generation of cephalosporin.Salmonella typhimurium was increasingly resistant to the third generation of cephalosporin in these years.Conclusions Most children with diarrhea caused by NTS infection are less than 1 year old in Guangzhou.The NTS infection peaks in summer and autumn.Salmonella typhimurium is the major and severely drug resistant serotype in Guangzhou.Antibiotics should be used reasonably basing on drug susceptibility test.