摘要
目的了解郑州大学附属儿童医院临床分离沙门菌的分布及耐药率。方法对2015年1月-2017年12月临床分离的沙门菌,按照统一方案,进行血清学分型及药敏试验,药敏结果按CLSI 2017年标准判读,数据统计用WHONET 5.6及SPSS 21.0进行分析。结果 2015-2017年共检出沙门菌274株。季节分布以夏秋季节为主,占74.82%(205/274);男女患儿性别比为1.4∶1;年龄分布以3岁以下婴幼儿组为主,占84.67%(232/274)。检出标本类型主要为粪便和血液标本。274株沙门菌共检测到31个血清型,以肠炎沙门菌36.86%(101/274)、鼠伤寒沙门菌36.50%(100/274)最多见。2015-2017年沙门菌对常用抗菌药物耐药率无明显变化,274株沙门菌对氨苄西林、哌拉西林耐药率最高,分别为84.6%、77.3%,对三代头孢菌素头孢噻肟、头孢他啶耐药率分别为32.5%、25.2%,共检出碳青霉烯类耐药沙门菌6株。粪便分离株对常见抗菌药物的耐药率普遍高于血液分离株,肠炎沙门菌对β-内酰胺类抗菌药物的耐药率高于鼠伤寒沙门菌。结论医院儿童检出沙门菌属季节分布以夏秋季高发,主要分离自3岁以下婴幼儿,血清型分布以肠炎沙门菌和鼠伤寒沙门菌为主,不同标本及血清型沙门菌对常见抗菌药物的耐药率各异,抗菌药物治疗要结合血清型及药敏结果慎重选择。
OBJECTIVE To understand the distribution and drug resistance rates of clinical Salmonella isolates in Children′s Hospital Affiliated to Zhengzhou University. METHODS According to the unified scheme, the serological typing and drug susceptibility testing were performed for the clinical isolates of Salmonella from Jan 2015 to De 2017, the result of drug susceptibility testing was interpreted based on the standards of CLSI 2017, and the data were statistically analyzed by using WHONET and SPSS 21.0 software. RESULTS A total of 274 strains of Salmonella were isolated from 2015 to 2017, 74.82%(205/274) of which were isolated in summer.The ratio of male children to female children was 1.4∶1.84.67%(232/274) of children were less than 3 years old.The strains were mainly isolated from the stool and blood specimens.Totally 31 serotypes were identified among the 274 strains of Salmonella, 36.86%(101/274) of which were Salmonella enteritidis, and 36.50%(100/274) were Salmonella typhimurium. The drug resistance rates of the Salmonella strains to the commonly used antibiotics did not change significantly, the drug resistance rates of the Salmonella strains to ampicillin and piperacillin were 84.6% and 77.3%, respectively, and the drug resistance rates to the third generation cephalosporins cefotaxime and ceftazidime were 32.5% and 25.2%, respectively.Totally 6 strains of carbapenem-resistant Salmonella were isolated.The drug resistance rates of the strains isolated from the stool specimens were generally higher than those of the strains isolated from the blood specimens;the drug resistance rates of the S. enteritidis strains to β-lactams were higher than those of the S. typhimurium strains. CONCLUSION The Salmonella strains are prevalent among the children in summer and autumn and are mainly isolated from the children aged less than 3 years old.The S. enteritidis and S. typhimurium are the major serotypes.The Salmonella strains isolated from different specimens vary in the resistance rates to the commonly used antibiotics, and it is necessary to reasonably use antibiotics based on the results of serological typing and drug susceptibility testing.
作者
高凯杰
杨俊文
贾静
阙蔚鹏
杨俊梅
李林飞
GAO Kai-jie;YANG Jun-wen;JIA Jing;QUE Wei-peng;YANG Jun-mei;LI Lin-fei(Children's Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan 450000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第1期120-124,共5页
Chinese Journal of Nosocomiology
基金
河南省医学科技攻关计划基金资助项目(2018020684)。
关键词
儿童
沙门菌
细菌耐药率监测
Child
Salmonella
Monitoring of bacterial resistance rate
