Zhou Yong, Liao Bin, Fang Huilong, Zeng Huiwen, Chen Cuimei, Huan Zheng-Hang, Zheng Wen, Liu Xun
School of Public Health, Xiangnan University, Chenzhou, China.
Chenzhou Center for Disease Control and Prevention, Chenzhou, China.
Transl Pediatr. 2024 Jun 30;13(6):921-930. doi: 10.21037/tp-24-120. Epub 2024 May 15.
is a significant pathogens of foodborne illness. The widespread use of antibiotics in clinical practice and animal husbandry has resulted in increasing drug resistance of . In this study, we examined the serotype distribution and drug resistance of in pediatric patients with diarrhea in Chenzhou City to provide a basis for the scientific control and rational use of antibiotics in clinical practice in relation to .
Stool . were collected from patients younger than 18 years of age who met the definition for foodborne illness at two sentinel hospitals from 2017 through 2022 tested , and a descriptive analysis of the epidemiologic characteristics. strains isolated from the stool underwent serology and drug-sensitivity tests. The following 14 antibiotics were used for the drug-sensitivity tests: ampicillin (AMP), ampicillin/sulbactam (AMS), cefazolin (CFZ), cefoxitin, cefotaxime, ceftazidime, imipenem (IPM), tetracycline (TET), nalidixic acid, ciprofloxacin, chloramphenicol (CHL), gentamicin, trimethoprim/sulfamethoxazole (SXT), and azithromycin.
Samples from 1,263 pediatric with diarrhea, and was detected in 221 (17.5%) of these patients. Positive test results were principally observed in the second and third quarters of each year, accounting for 21.1% and 19.6% of the cases, respectively. The infection rates of infants aged less than 12 months and toddlers aged 1-3 years with diarrhea were the highest at 21.3% and 17.8%, respectively. The 221 strains were divided into 32 serotypes, of which Typhimurium ( Typhimurium) was the dominant strain (79.2%). The resistance rates to TET (86.9%), AMP (75.6%), AMS (58.4%), CFZ (55.7%), CHL (54.3%), and SXT (45.2%) predominated, and the differences in the drug-resistance rates to 1-, 2-, and 3-generation cephalosporins were high (2.3-55.7%). Only 0.9% of the strains were resistant to IPM. The multidrug resistance (MDR) rate was 76.5% (169/221), and 48.9% (108/221) of the strains were resistant to five or more classes of antibiotics, of which the most common drug-resistance profile was AMP-AMS-TET-CHL-CFZ-SXT, accounting for 10.9% of Salmonella strains (24/221).
Foodborne salmonellosis tended to occur during the summer and autumn in children, and infants and toddlers were more likely to develop salmonellosis than children in the other age groups. The dominant serotype was . Typhimurium. The drug-resistance rate of the tested strains was high, and the MDR problem was severe. We recommend that in the treatment of salmonellosis, antibiotics be selected rationally based on the drug-resistance status of local resistance situation to ensure safety and efficacy.
是食源性疾病的重要病原体。抗生素在临床实践和畜牧业中的广泛使用导致其耐药性不断增加。在本研究中,我们调查了郴州市腹泻患儿中的血清型分布及耐药情况,为临床针对的科学防控及合理使用抗生素提供依据。
收集2017年至2022年期间,两家哨点医院中符合食源性疾病定义的18岁以下腹泻患儿的粪便样本进行检测,并对流行病学特征进行描述性分析。对从粪便中分离出的菌株进行血清学和药敏试验。药敏试验使用以下14种抗生素:氨苄西林(AMP)、氨苄西林/舒巴坦(AMS)、头孢唑林(CFZ)、头孢西丁、头孢噻肟、头孢他啶、亚胺培南(IPM)、四环素(TET)、萘啶酸、环丙沙星、氯霉素(CHL)、庆大霉素、甲氧苄啶/磺胺甲恶唑(SXT)和阿奇霉素。
共采集了1263例腹泻患儿的样本,其中221例(17.5%)检测出。阳性检测结果主要出现在每年的第二和第三季度,分别占病例的21.1%和19.6%。12个月以下婴儿和1 - 3岁幼儿腹泻感染率最高,分别为21.3%和17.8%。221株菌株分为32个血清型,其中鼠伤寒沙门氏菌(鼠伤寒沙门氏菌)是优势菌株(79.2%)。对TET(86.9%)、AMP(75.6%)、AMS(58.4%)、CFZ(55.7%)、CHL(54.3%)和SXT(45.2%)的耐药率较高,对1 - 3代头孢菌素的耐药率差异较大(2.3 - 55.7%)。仅0.9%的菌株对IPM耐药。多重耐药(MDR)率为76.5%(169/221),48.9%(108/221)的菌株对五类及以上抗生素耐药,其中最常见的耐药谱为AMP - AMS - TET - CHL - CFZ - SXT,占沙门氏菌菌株的10.9%(24/221)。
食源性沙门氏菌病在儿童中多发生于夏秋季节,婴幼儿比其他年龄组儿童更易感染沙门氏菌病。优势血清型为鼠伤寒沙门氏菌。受试菌株耐药率高,多重耐药问题严重。建议在沙门氏菌病治疗中,根据当地的耐药情况合理选用抗生素,以确保用药安全有效。