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[2022 - 2023年中国成都0 - 6岁儿童侵袭性非伤寒性肠炎的临床及药敏特征]

[Clinical and drug sensitivity characteristics of invasive non-typhoidal enteritis in children aged 0-6 years in Chengdu, China, 2022-2023].

作者信息

Yang Ling-Rong, Zhou Chun-Ting, Guo Jing, Wu Yu-Lu, Xiong Fu

机构信息

Department of Pediatric Gastroenterology, Sichuan Provincial Women's and Children's Hospital/Women's and Children's Hospital Affiliated to Chengdu Medical College, Chengdu 610000, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2025 Mar 15;27(3):315-320. doi: 10.7499/j.issn.1008-8830.2408085.

Abstract

OBJECTIVES

To investigate the clinical characteristics and drug resistance profile of invasive non-typhoidal (NTS) enteritis in children in Chengdu, China, providing a reference for rational drug use and empirical treatment in clinical practice.

METHODS

A retrospective analysis was conducted on the clinical data of 130 children with invasive bacterial enteritis due to NTS identified by fecal bacterial culture and the results of drug sensitivity tests for NTS in Chengdu from January 2022 to December 2023.

RESULTS

NTS infections were mainly observed from April to September (113 cases, 86.9%), with a peak in August (36 cases, 27.7%). Children aged <36 months accounted for 86.2% (112/130) of all cases, and the main symptoms were diarrhea (130 cases, 100%), fever (123 cases, 94.6%), and hematochezia (112 cases, 86.2%). The 130 NTS isolates exhibited a sensitivity rate of 64.6% to ceftriaxone and 63.8% to cefotaxime, and a sensitivity rate of >90.0% to piperacillin-tazobactam and nitrofurantoin (nitrofurans). The detection rate of multidrug-resistant strains was 48.5% (63/130), and the clinical efficacy of third-generation cephalosporins used in 38 patients (29.2%) was inconsistent with the results of drug sensitivity tests.

CONCLUSIONS

The peak of invasive NTS enteritis in children aged 0-6 years occurs in August in the Chengdu area, with a relatively high incidence rate in children aged <36 months. The situation of drug resistance is severe for NTS, and piperacillin-tazobactam may be an effective option for treating multidrug-resistant NTS infections in children, while nitrofuran antibiotics might be used to treat such infections.

摘要

目的

调查中国成都地区儿童侵袭性非伤寒沙门菌(NTS)肠炎的临床特征及耐药情况,为临床合理用药及经验性治疗提供参考。

方法

对2022年1月至2023年12月在成都通过粪便细菌培养确诊为侵袭性NTS肠炎的130例儿童的临床资料及NTS药敏试验结果进行回顾性分析。

结果

NTS感染主要发生在4至9月(113例,86.9%),8月达到高峰(36例,27.7%)。年龄<36个月的儿童占所有病例的86.2%(112/130),主要症状为腹泻(130例,100%)、发热(123例,94.6%)和便血(112例,86.2%)。130株NTS分离株对头孢曲松的敏感率为64.6%,对头孢噻肟的敏感率为63.8%,对哌拉西林-他唑巴坦和呋喃妥因(硝基呋喃类)的敏感率>90.0%。多重耐药菌株的检出率为48.5%(63/130),38例患者(29.2%)使用第三代头孢菌素的临床疗效与药敏试验结果不一致。

结论

成都地区0-6岁儿童侵袭性NTS肠炎高峰出现在8月,<36个月儿童发病率相对较高。NTS耐药情况严峻,哌拉西林-他唑巴坦可能是治疗儿童多重耐药NTS感染的有效选择,呋喃类抗生素可用于此类感染的治疗。

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