深圳市儿童医院儿童粪便分离的459株沙门菌分布特征及耐药性

目的了解儿童粪便分离沙门菌的分布特征及耐药情况。 方法分析2012年1月—2015年10月某院患儿粪便标本分离的沙门菌检出情况，以及沙门菌血清型和对常用抗菌药物的敏感性。 结果7 047例患儿送检粪便标本，459例患儿检出沙门菌，总检出率为6.51%。沙门菌肠炎患儿男女比为2.4︰1，其中3岁以下儿童352例（占76.69%）；459株沙门菌中5—10月份检出374株（占81.48%），7、8、9月检出数量最多，分别为72、84、78株。沙门菌血清型主要为B群(69.06%)和D群（19.39%），分别以鼠伤寒沙门菌和肠炎沙门菌血清型为主。未检出耐亚胺培南和厄他培南的菌株，沙门菌属对哌拉西林/他唑巴坦、头孢吡肟、头孢他啶、氨曲南和头孢曲松的敏感率均＞70%，肠炎沙门菌对头孢类抗生素的敏感率低于鼠伤寒沙门菌，但对复方磺胺甲口恶唑的敏感率高于鼠伤寒沙门菌。结论该院儿童粪便检出的沙门菌主要分离自3岁以下婴幼儿，夏秋季节高发，血清型以鼠伤寒和肠炎沙门菌为主，抗菌药物治疗要结合血清型及药敏结果慎重选择。

Distribution characteristics and antimicrobial resistance of 459 strains of Salmonella isolated from feces of children in Shenzhen Children’s Hospital

ObjectiveTo understand the distribution characteristics and antimicrobial resistance of Salmonella isolated from feces of children. MethodsSalmonella were isolated from fecal specimens of children in a hospital between January 2012 and October 2015, serotypes and susceptibility of Salmonella to commonly used antimicrobial agents were analyzed. ResultsA total of 7 047 children’s fecal specimens were detected, 459 (6.51%) children were isolated Salmonella, the ratio of male to female was 2.4∶1, 352 (76.69%) children were less than 3 years old; 374 strains (81.48%） were isolated from May to October, the numbers of stains isolated in July, August, and September were 72, 84, and 78 respectively. Salmonella group B and group D were the most common serotypes, accounting for 69.06% and 19.39% respectively, most were serotypes of Salmonella typhimurium (S. typhimurium) and Salmonella enteritidis (S. enteritidis). No imipenem or ertapenem resistant strains were found, susceptibility of Salmonella to piperacillin/tazobactam, cefepime, ceftazidime, aztreonam, and ceftriaxone were all>70%, susceptibility rate of S. enteritidis to cephalosporins was lower than S. typhimurium, but to compound sulfamethoxazole was higher than S. typhimurium. ConclusionSalmonella are mainly isolated from children less than 3 years old in this hospital, summer and autumn are peak seasons, the main serotypes were S. typhimurium and S. enteritidis, antimicrobial therapy should be carefully selected in combination with serotypes and antimicrobial susceptibility testing result.