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[非伤寒沙门氏菌血清型引起的肠外感染。9年经验]

[Extra-intestinal infections caused by non-typhi Salmonella serotypes. 9 yrs' experience].

作者信息

Ruiz M, Rodríguez J C, Elía M, Royo G

机构信息

Sección de Microbiología, Hospital General, Alicante.

出版信息

Enferm Infecc Microbiol Clin. 2000 May;18(5):219-22.

Abstract

BACKGROUND

The most characteristic finding in non typhoid Salmonella serotype infection is acute gastroenteritis which is usually benign and self-limiting. However, more serious extraintestinal findings, such as bacteraemia and focal infections localized to any organ may appear.

PATIENTS AND METHODS

The objective of this article is to describe the most important characteristics of the extraintestinal infections due to non typhoid Salmonella serotypes observed in our hospital between December 1991 and August 1999. To do so, we reviewed the clinical histories of patients in which extraintestinal non typhoid Salmonella serotypes was isolated, applying a clinicomicrobiological protocol.

RESULTS

Salmonella enterica was isolated on 1,543 occasions, of which 25 (1.6%) were Salmonella serotype Typhi and 1,518 (98.3%) non typhoid serotypes. Of the patients with non typhoid serotypes infections, 27 had extraintestinal infection (1.8%). The most frequently isolated was the serotype typhimurium (50% of cases) followed by enteritidis (26% of cases) and hadar (7.1% of cases). Regarding the clinical picture, bacteraemias secondary to gastroenteritis and focal infections occurred with the same frequency (35.7%); the remaining were primary bacteraemias. Eight patients were under 10 years of age and 15 patients were over 60. In 57.1% of the patients there was underlying disease.

CONCLUSIONS

Extraintestinal non typhoid Salmonella serotypes infections make up 1.8% of all salmonellosis and most of them occur in childhood or in the elderly. Transitory bacteraemias in the context of acute gastroenteritis occur mainly in children. The greatest risk of acquiring focal infections is associated with the existence of underlying illness or immunodepression.

摘要

背景

非伤寒沙门菌血清型感染最典型的表现是急性肠胃炎,通常为良性且具有自限性。然而,可能会出现更严重的肠外表现,如菌血症以及局限于任何器官的局灶性感染。

患者与方法

本文的目的是描述1991年12月至1999年8月间在我院观察到的非伤寒沙门菌血清型引起的肠外感染的最重要特征。为此,我们采用临床微生物学方案,回顾了分离出肠外非伤寒沙门菌血清型的患者的临床病史。

结果

共1543次分离出肠炎沙门菌,其中25例(1.6%)为伤寒沙门菌血清型,1518例(98.3%)为非伤寒血清型。在非伤寒血清型感染患者中,27例发生了肠外感染(1.8%)。最常分离出的血清型是鼠伤寒血清型(占病例的50%),其次是肠炎血清型(占病例的26%)和哈达尔血清型(占病例的7.1%)。关于临床表现,肠胃炎继发的菌血症和局灶性感染发生率相同(均为35.7%);其余为原发性菌血症。8例患者年龄在10岁以下,15例患者年龄在60岁以上。57.1%的患者有基础疾病。

结论

肠外非伤寒沙门菌血清型感染占所有沙门菌病的1.8%,其中大多数发生在儿童期或老年期。急性肠胃炎时的短暂菌血症主要发生在儿童身上。发生局灶性感染的最大风险与基础疾病或免疫抑制的存在有关。

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