2018-2025年广州市某妇幼保健院沙门菌肠炎临床特征及耐药性

Clinical characteristics and antimicrobial resistance of Salmonella enteritis isolates from a maternal and child health hospital in Guangzhou from 2018 to 2025

  • 摘要:
    目的 分析广州地区0~14岁腹泻儿童沙门菌感染的血清学分型、临床症状和耐药特征。
    方法 收集2018-2025年广州市某妇幼保健院粪便沙门菌培养阳性患儿的基本信息、病例资料、血清型和药敏试验结果,并进行回顾性分析。
    结果 2018-2025年沙门菌总检出率为22.89%(1 844/8 057),各年度检出率总体呈上升趋势(P<0.001)。<1岁组和1~3岁组的检出率高于>3~6岁组和>6~14岁组(P<0.05)。共检出25种血清型,鼠伤寒沙门菌占比最高。不同年龄组的血清群构成比差异有统计学意义(P<0.001),患儿以腹泻和发热为主要表现。沙门菌对不同抗菌药物的耐药率差异有统计学意义(P<0.001)。不同血清群沙门菌对氨苄西林、头孢他啶、头孢曲松、环丙沙星及磺胺甲噁唑/甲氧苄啶的耐药率差异有统计学意义(P<0.05)。头孢他啶、头孢曲松和磺胺甲噁唑/甲氧苄啶的耐药率呈上升趋势(P<0.05)。
    结论 广州地区儿童沙门菌感染主要发生于3岁以下儿童,血清型构成呈多样性,以鼠伤寒沙门菌为主。沙门菌对氨苄西林的耐药率较高,且对头孢他啶、头孢曲松、磺胺甲噁唑/甲氧苄啶的耐药率呈上升趋势,应加强耐药监测并指导临床合理用药。

     

    Abstract:
    OBJECTIVE To analyze the serotypes, clinical symptoms and antimicrobial resistance characteristics of Salmonella infections in children aged 0 to 14 years with diarrhea in Guangzhou.
    METHOD The basic information, case data, serotypes and antimicrobial susceptibility results of children with Salmonella-positive stool cultures from a maternal and child health hospital in Guangzhou (2018–2025) were collected for retrospective analysis.
    RESULTS The overall detection rate of Salmonella from 2018 to 2025 was 22.89% (1 844/8 057), with a generally increasing trend in annual detection rates (P<0.001). The detection rates in the <1-year and 1- to 3-year age groups were significantly higher than those in the >3- to 6-year and >6- to 14-year age groups (P<0.05). A total of 25 serotypes were detected, with Salmonella typhimurium having the highest proportion. The serogroup composition differed significantly across age groups (P<0.001). Diarrhea and fever were the main manifestations in the children. Resistance rates of Salmonella to the tested antimicrobial agents varied significantly (P<0.001). Statistically significant differences in resistance rates to ampicillin, ceftazidime, ceftriaxone, ciprofloxacin and trimethoprim-sulfamethoxazole were observed among different serogroups (P<0.05). The antimicribial resistance rates to ceftazidime, ceftriaxone, and sulfamethoxazole/trimethoprim showed an increasing trend (P<0.05).
    CONCLUSIONS Salmonella infections among children in Guangzhou mainly occur in those under 3 years old, with a diverse serotype distribution dominated by S. typhimurium. Salmonella exhibits a high resistance rate to ampicillin, and the resistance rates to ceftazidime, ceftriaxone and sulfamethoxazole/trimethoprim show an increasing trend. Antimicrobial resistance monitoring should be strengthened to guide rational clinical drug use.

     

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