Department of Clinical Bacteriology, Parasitology, Zoonoses and Geographic Medicine, University Hospital of Heraklion, Crete, Greece.
Eur J Clin Microbiol Infect Dis. 2012 Aug;31(8):1889-94. doi: 10.1007/s10096-011-1517-2. Epub 2011 Dec 30.
In this study, we investigated the long-term trends in the epidemiology and susceptibility of bacterial enteropathogens among children in a well-defined area of adequate health standards. The study included all children younger than 14 years of age treated for enteritis at Heraklion University General Hospital on the island of Crete during the 18-year period from January 1993 to December 2010. Stool specimens were tested for Salmonella, Shigella, Campylobacter, enteropathogenic Escherichia coli (EPEC), Yersinia, and Aeromonas species. Of the 33,032 stool samples from patients of any age, 2,912 (8.82%) were positive for bacterial enteropathogens. The 1,597 isolates from children were identified as S. enterica (42.3%), Campylobacter spp. (33.6%), EPEC (17.4%), Y. enterocolitica (5.82%), A. hydrophila (0.44%), and Shigella spp. (0.38%). A decline in prevalence was observed for all bacterial enteropathogens. Taken as a total, enteropathogens were susceptible to gentamicin, ceftriaxone, ciprofloxacin, co-trimoxazole, and amoxicillin in 98.8%, 88.0%, 83.0%, 67.1%, and 59.6%, respectively. During the study period, the susceptibility rates decreased for co-trimoxazole (p<0.0001) and ciprofloxacin (p<0.001), and increased for amoxicillin (p<0.0001). Our findings suggest declining long-term trends in the prevalence of bacterial enteropathogens and changes in susceptibility rates to first-line antibacterial agents. These changing trends in the long-term morbidity and susceptibility call for ongoing surveillance and tailored management.
在这项研究中，我们调查了在克里特岛赫拉克勒翁大学综合医院接受肠炎治疗的 14 岁以下儿童中，在充分卫生标准的明确区域内，细菌肠道病原体的流行病学和易感性的长期趋势。研究包括在 1993 年 1 月至 2010 年 12 月的 18 年期间，所有因肠炎而在该医院接受治疗的年龄在 14 岁以下的儿童。对粪便标本进行了沙门氏菌、志贺氏菌、弯曲杆菌、肠致病性大肠杆菌（EPEC）、耶尔森氏菌和气单胞菌属的检测。在来自任何年龄段患者的 33032 个粪便样本中，有 2912 个（8.82%）呈细菌肠道病原体阳性。从儿童中分离出的 1597 株分离物鉴定为肠沙门氏菌（42.3%）、弯曲杆菌属（33.6%）、EPEC（17.4%）、耶尔森氏菌肠亚种（5.82%）、嗜水气单胞菌（0.44%）和志贺氏菌属（0.38%）。所有细菌肠道病原体的流行率均呈下降趋势。总体而言，肠道病原体对庆大霉素、头孢曲松、环丙沙星、复方新诺明和阿莫西林的敏感性分别为 98.8%、88.0%、83.0%、67.1%和 59.6%。在研究期间，复方新诺明（p<0.0001）和环丙沙星（p<0.001）的敏感性下降，阿莫西林（p<0.0001）的敏感性增加。我们的研究结果表明，细菌肠道病原体的流行率呈长期下降趋势，对一线抗菌药物的敏感性也发生了变化。这些长期发病率和敏感性的变化趋势需要持续监测和有针对性的管理。
