a From the Division of Infectious Diseases , Children's Hospital of Michigan Wayne State University , Detroit , MI , USA and.
b From the Carman and Ann Adams Department of Pediatrics , Wayne State University , Detroit , MI , USA.
Infect Dis (Lond). 2016 Feb;48(2):147-51. doi: 10.3109/23744235.2015.1094823. Epub 2015 Oct 12.
Salmonella gastroenteritis, usually self- limited, can result in bacteremia and focal disease. This study was undertaken to determine the role of age and infecting Salmonella serotype on the risk of bacteremia in children.
This was a review of medical records of children with positive nontyphoidal Salmonella cultures seen in an urban setting at the Children's Hospital of Michigan in Detroit between July 1993 and December 2007.
Isolates recovered from 633 patients, representing 50 serotypes, included 594 positive stool cultures and 72 (11.4% of all patients) positive blood cultures. Salmonella serotype Typhimurium was the most common serotype, accounting for 29.4% (186/633) of isolates, of which only 3 (1.6%) were recovered from blood. The most common serotype recovered from blood was serotype Heidelberg (40/120 of patients with Heidelberg serotype) accounting for 55.5% (40/72) of positive blood cultures. The patients' age range was 2 weeks to 20 years, with a median of 7 months (interquartile range, IQR = 4-23 months). Bacteremic patients (n = 72) had a median age of 6.5 months (IQR = 4-11 months) and were comparable in age to non-bacteremic patients (n = 266), who had a median age of 5.5 months (IQR = 3-11 months) (p = 0.24). The odds ratio (OR) for bacteremia in patients infected with serotype Typhimurium was 0.21 and in patients with serotype Heidelberg was 4.0. Patients with serotype Heidelberg infection in the age groups < 3 months, 3-6 months, 6-12 months, and > 12 months had an OR for bacteremia of 9.2, 2.5, 3.2, and 6.0, respectively.
In our patient population, children with Salmonella serotype Heidelberg infection are at higher risk of bacteremia than children infected with other Salmonella serotypes. The risk is highest during the first 3 months of life.
沙门氏菌肠胃炎通常是自限性的，但可导致菌血症和局部疾病。本研究旨在确定年龄和感染的沙门氏菌血清型在儿童菌血症风险中的作用。
这是对 1993 年 7 月至 2007 年 12 月在底特律密歇根儿童医院接受非伤寒沙门氏菌培养阳性的城市儿童的病历进行的回顾性研究。
从 633 例患者中分离出 50 种血清型的分离株，包括 594 例粪便培养阳性和 72 例（所有患者的 11.4%）血培养阳性。血清型鼠伤寒沙门氏菌是最常见的血清型，占 29.4%（186/633）的分离株，其中仅 3 株（1.6%）从血液中分离出来。从血液中分离出的最常见血清型是血清型海德堡（40/120 例海德堡血清型患者），占阳性血培养物的 55.5%（40/72）。菌血症患者（n=72）的年龄范围为 2 周至 20 岁，中位数为 7 个月（四分位距 IQR=4-23 个月）。菌血症患者（n=72）的中位年龄为 6.5 个月（IQR=4-11 个月），与非菌血症患者（n=266）的年龄相似，非菌血症患者的中位年龄为 5.5 个月（IQR=3-11 个月）（p=0.24）。感染血清型鼠伤寒沙门氏菌的患者发生菌血症的比值比（OR）为 0.21，感染血清型海德堡的患者为 4.0。3 个月以下、3-6 个月、6-12 个月和>12 个月的血清型海德堡感染患儿菌血症的比值比（OR）分别为 9.2、2.5、3.2 和 6.0。
在我们的患者人群中，感染血清型海德堡的沙门氏菌患儿发生菌血症的风险高于感染其他血清型沙门氏菌的患儿。风险在生命的头 3 个月最高。
