Wen Sophie Ch, Best Emma, Nourse Clare
Infection Management and Prevention Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia.
Department of Paediatric Infectious Diseases, Starship Children's Hospital, Auckland, New Zealand.
J Paediatr Child Health. 2017 Oct;53(10):936-941. doi: 10.1111/jpc.13585. Epub 2017 May 29.
Non-typhoidal Salmonellae are a major cause of infectious diarrhoea worldwide and can cause invasive diseases, including bacteraemia, meningitis and osteomyelitis. Young or immunocompromised children and those with underlying conditions such as sickle cell disease are particularly vulnerable to invasive disease. There has been an increase in the rate of resistant non-typhoidal Salmonella, which is associated with invasive disease and hospitalisation. The intracellular nature of non-typhoidal Salmonella protects against extracellular antibiotics and can facilitate disease relapse, particularly meningitis. Effective antimicrobial agents with good intracellular penetration include azithromycin, fluoroquinolones and third-generation cephalosporins. Antibiotic treatment of non-typhoidal Salmonella gastroenteritis is only indicated if there are risk factors for invasive disease as it can prolong excretion and does not shorten the duration of gastrointestinal symptoms. Optimal choice and length of therapy for gastroenteritis and invasive disease in children is not clear. Here, we provide a review of the literature and treatment recommendations.
非伤寒沙门氏菌是全球感染性腹泻的主要病因，可引发侵袭性疾病，包括菌血症、脑膜炎和骨髓炎。年幼或免疫功能低下的儿童以及患有镰状细胞病等基础疾病的儿童尤其易患侵袭性疾病。耐药非伤寒沙门氏菌的发生率有所上升，这与侵袭性疾病和住院治疗有关。非伤寒沙门氏菌的细胞内特性可抵御细胞外抗生素，并可能促使疾病复发，尤其是脑膜炎。具有良好细胞内穿透力的有效抗菌药物包括阿奇霉素、氟喹诺酮类和第三代头孢菌素。非伤寒沙门氏菌性胃肠炎只有在存在侵袭性疾病风险因素时才需要进行抗生素治疗，因为抗生素治疗会延长细菌排泄时间，且不会缩短胃肠道症状的持续时间。儿童胃肠炎和侵袭性疾病的最佳治疗选择和疗程尚不清楚。在此，我们对相关文献进行综述并给出治疗建议。
