北京市肠道门诊腹泻儿童沙门菌感染状况和耐药性分析

发布时间：2018-10-20 07:01

【摘要】：目的分析北京市2010-2015年5岁以下腹泻儿童沙门菌感染的流行病学特征及耐药性。方法从17家肠道门诊采集患儿粪便标本,进行沙门菌分离鉴定、血清分型及药敏试验。结果 3 428份腹泻患儿粪便,沙门菌阳性检出率为4.6%,以3~4岁患儿为主。全年均有检出,除4月份有1个明显的高峰外,夏秋季是持续的检出高峰。分离到33种沙门菌血清型,其中肠炎沙门菌占34.6%,鼠伤寒沙门菌占16.0%。沙门菌对磺胺异VA唑(60.6%)、萘啶酸(56.8%)、链霉素和氨苄西林(50.3%)等经典抗生素有很高的耐药性;对阿莫西林-克拉维酸、四环素和强力霉素呈现中度耐药,耐药率分别为47.1%,31.0%和29.7%;对头孢曲松、头孢吡肟和环丙沙星耐药率为7.7%、3.9%和7.1%。多重耐药菌株随着年代的增加而呈明显上升趋势,至少耐3种以上抗生素的菌株占58.1%。结论北京市腹泻儿童沙门菌感染以3~4岁高发,肠炎沙门菌和鼠伤寒沙门菌为主要血清型,多重耐药日趋严重,临床上应合理规范用药。
[Abstract]:Objective to analyze the epidemiological characteristics and drug resistance of Salmonella infection in children under 5 years old in Beijing from 2010 to 2015. Methods fecal specimens were collected from 17 patients with intestinal diseases. Salmonella was isolated and identified, serotyping and drug sensitivity test were performed. Results the positive rate of Salmonella in feces of 3 428 children with diarrhea was 4.6%, mainly 3 years old and 4 years old. Except for one obvious peak in April, there was a continuous peak in summer and autumn. 33 Salmonella serotypes were isolated, of which Salmonella enteritis accounted for 34.6m and Salmonella typhimurium accounted for 16.0. Salmonella showed high resistance to classical antibiotics such as sulfamethoxazole (60.6%), naphthalic acid (56.8%), streptomycin and ampicillin (50.3%), and showed moderate resistance to amoxicillin clavulanic acid, tetracycline and doxycycline. The drug resistance rates of ceftriaxone, cefepime and ciprofloxacin were 31.0% and 29.7%, respectively, and were 7.7% and 7.1% for ceftriaxone, cefepime and ciprofloxacin, respectively. The multidrug resistant strains showed an obvious upward trend with the increase of age, and at least three kinds of antibiotic resistant strains accounted for 58.1%. Conclusion Salmonella infection in children with diarrhea in Beijing is high in age 3 and 4 years old. Salmonella enteritidis and Salmonella typhimurium are the main serotypes, and multidrug resistance is becoming more and more serious.
【作者单位】：北京市疾病预防控制中心北京市预防医学研究中心食物中毒诊断溯源技术北京市重点实验室;
【基金】：北京市高层次卫生技术人才培养计划(2013-3-099) “十三五”传染病国家科技重大专项(2017ZX10104002-003-002)
【分类号】：R446.5;R725.1

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