摘要
目的:探讨小儿复杂型鼠伤寒沙门菌感染治疗特点、药敏结果及抗菌药物使用方案。方法:回顾性分析2012年12月-2018年12月本院收治的52例小儿复杂型鼠伤寒沙门菌感染患儿的临床资料及药敏结果,分析其治疗特点、药敏结果、抗菌药物使用方案。结果:52例复杂型鼠伤寒沙门菌感染患儿治疗中,抗菌药物选择青霉素类/头孢类43例(82.69%),碳青霉烯类9例(17.31%)。总治愈2周内33例(63.46%),2~4周11例(21.15%),1~3个月4例(7.69%),4~6个月2例(3.85%),除外失访2例均达临床治愈。总大便培养阴转时间,<1周17例(32.54%),1~2周19例(36.54%),3~4周8例(15.38%),>4周6例(11.54%)。药敏试验提示鼠伤寒沙门菌对碳青霉烯类药物敏感率达100%,对含酶抑制剂三代头孢及青霉素类药物头孢哌酮舒巴坦、哌拉西林钠他唑巴坦敏感率亦较高,不含酶头孢素/青霉素类、复方磺胺甲噁唑、氟喹诺酮类药物敏感率有所下降,氨苄西林、阿莫西林克拉维酸钾敏感率更低。结论:治疗小儿复杂型鼠伤寒沙门菌感染可优先考虑含酶抑制剂的三代头孢/青霉素类,如头孢哌酮舒巴坦、哌拉西林钠他唑巴坦;在缺乏药敏时,不含酶抑制剂的青霉素类/头孢类,复方磺胺甲噁唑,或敏感度相对不够高的阿莫西林克拉维酸钾等选择应慎重,如需选择应参照药敏。喹诺酮类药物虽不推荐,但仍是治疗可能危及生命的多重药耐药沙门菌属感染的无其他替代药物时可选择的药物。
Objective:To explore the treatment characteristics,drug sensitivity analysis and antimicrobial use of complex Salmonella typhimurium infection in children.Method:The clinical data and drug sensitivity of 52 children with complex Salmonella typhimurium infection in our hospital from December 2012 to December 2018 were analyzed retrospectively,and the characteristic treatment,drug sensitivity results and antibiotic use program were analyzed.Result:Among 52 patients with complex Salmonella typhimurium infection,43 cases(82.69%)were penicillins/cephalosporins,9 cases(17.31%)were carbapenems.33 cases(63.46%)were cured in 2 weeks,11 cases(21.15%)in 2-4 weeks,4 cases(7.69%)in 1-3 months,2 cases(3.85%)in 4-6 months,except for 2 cases of lost visit.The total negative time of stool culture was less than 1 week in 17 cases(32.54%),1-2 weeks in 19 cases(36.54%),3-4 weeks in 8 cases(15.38%),and>4 weeks in 6 cases(11.54%).The drug sensitivity test showed that the sensitivity rate of Salmonella typhimurium to carbapenems was 100%,the sensitivity of Ceftazidime to Cefoperazone Sulbactam and Piperacilatrazolactam,the third generation cephalosporins and penicillins containing enzyme inhibitors,was also higher.The sensitivity of ceftazidime/penicillin,Sulfamethoxazole and fluoroquinolones without enzyme decreased,while the sensitivity of Ampicillin and Amoxicillin Clavulanate Potassium were lower.Conclusion:In the treatment of complex Salmonella typhimurium infection in children,the third generation cephalosporins/penicillins with enzyme inhibitors should be given priority,such as Cefoperazone Sulbactam and Piperacilattazobactam.In the absence of drug sensitivity,penicillins/cephalosporins without enzyme inhibitors,Compound Sulfamethoxazole,or Amoxicillin Clavulanate Potassium with relatively high sensitivity should be selected carefully,if necessary drug sensitivity should be considered.Although quinolones are not recommended,they are still the alternative drugs for the treatment of life-threatening multidrug-resistant Salmonella infections.
作者
赵夜
林菁
赖宗乐
ZHAO Ye;LIN Jing;LAI Zongle(Guangzhou Eighth People’s Hospital,Guangzhou 510440,China;不详)
出处
《中国医学创新》
CAS
2020年第15期121-125,共5页
Medical Innovation of China
关键词
鼠伤寒沙门菌感染
小儿
临床特点
药敏分析
Salmonella typhimurium infection
Children
Clinical characteristics
Drug sensitivity analysis
