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90 例小儿肠炎沙门菌感染的临床特点及耐药性分析。

Clinical Characteristics and Drug Resistance Analysis of 90 Cases of Children with Salmonella Enteritis.

机构信息

Maternal and Child Health Hospital of Hubei Province, China.

Women and Children's Hospital of Hubei Province, China.

出版信息

Comput Math Methods Med. 2022 Aug 3;2022:5091945. doi: 10.1155/2022/5091945. eCollection 2022.

Abstract

OBJECTIVE

To summarize the clinical characteristics and drug sensitivity analysis of children with Salmonella enteritis in our hospital, explore the characteristics and drug resistance of Salmonella infection, and guide the rational clinical use of drugs.

METHODS

The clinical data of 90 pediatric Salmonella enteritis patients treated in our hospital from January 2015 to January 2020 were selected as the observation group of this retrospective study, and 90 patients with non-Salmonella enteritis were selected at the same time as a control group. Discuss the clinical characteristics of Salmonella, drug sensitivity analysis, infection characteristics, and drug resistance and guide the rational clinical use of drugs.

RESULTS

The susceptibility rates of 15 antibiotics from high to low were imipenem and meropenem, piperacillin, cefoperazone, compound trimethoprim, chloramphenicol, and ceftazidime. Salmonella strains were both resistant to imipenem and meropenem. Salmonella is sensitive and has a low rate of resistance to quinolones (ciprofloxacin) and a high rate of resistance to cephalosporins (ceftriaxone, cefotaxime, ceftazime, and cefpiramide), both reached more than 28%. Salmonella has the highest resistance to penicillin and erythromycin, both at 85.00% and above. Among 90 children with Salmonella enteritidis food poisoning, 32 were hospitalized, 21 cases were hospitalized less than 7 days, and 11 cases were 7-14 days. The longest hospital stay was 12 days, the shortest was 1 day, and the average was 6.1 days. Seven people stayed for observation and 51 people were discharged after treatment. All the children recovered without death.

CONCLUSION

In clinical practice, antibiotics should be used rationally based on drug susceptibility results. In the case of poor efficacy of cephalosporins, amoxicillin and potassium clavulanate, piperacillin, tazobactam, or imipenem, cephalosporin antibiotics can be considered the first choice for clinical empiric medication.

摘要

目的

总结我院小儿肠炎沙门菌感染的临床特点及药敏分析,探讨沙门菌感染的特点及耐药性,指导临床合理用药。

方法

选取我院 2015 年 1 月至 2020 年 1 月收治的 90 例小儿肠炎沙门菌感染患儿的临床资料作为回顾性研究的观察组,并同时选取 90 例非肠炎沙门菌感染患儿作为对照组。讨论肠炎沙门菌的临床特点、药敏分析、感染特点及耐药性,指导临床合理用药。

结果

15 种抗生素的敏感率从高到低依次为亚胺培南、美罗培南、哌拉西林、头孢哌酮、复方磺胺甲噁唑、氯霉素、头孢他啶。沙门菌菌株均对亚胺培南和美罗培南耐药,对喹诺酮类(环丙沙星)敏感,对头孢菌素(头孢曲松、头孢噻肟、头孢他啶、头孢吡肟)耐药率高,均超过 28%。沙门菌对青霉素和红霉素的耐药率最高,均在 85.00%以上。90 例小儿肠炎沙门菌食物中毒患儿中,32 例住院,21 例住院时间小于 7 天,11 例 7-14 天,最长住院时间 12 天,最短 1 天,平均 6.1 天。7 例留观,51 例治疗后出院。所有患儿均痊愈,无死亡。

结论

临床实践中应根据药敏结果合理使用抗生素,头孢菌素疗效不佳时,可考虑选用阿莫西林克拉维酸钾、哌拉西林他唑巴坦、或亚胺培南、头孢菌素类抗生素作为临床经验性用药的首选。

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