[马德里市区一家医院非伤寒沙门氏菌病的流行病学概况（1980 - 1994年）] - Suppr

Ramos J M, Cuenca-Estrella M, Alés J M, Soriano F

Departamento de Microbiología Médica, Fundación Jiménez Díaz, Madrid.

Enferm Infecc Microbiol Clin. 1996 Jun-Jul;14(6):345-51.

BACKGROUND

The aim of this study was to describe the epidemiologic profile of non-typhoid salmonellosis at a general hospital in the metropolitan area of Madrid.

METHODS

A descriptive and retrospective study of non-typhoid salmonellosis diagnosed at Microbiology Department of Fundación Jiménez Díaz from May 1980 to December 1994 was done.

RESULTS

Non-typhoid Salmonella (NTS) was identified in 1796 specimens of 1463 patients, 520 (35.5%) were under 15 years and 943 (64.5%) were over 14 years. The infection was intestinal in 1288 (88%) cases, bacteremic in 129 (8.8%) and focal in 46 (3.1%). The extraintestinal infection was most frequent in patients over 14 years (15.5% versus 5.6%; p < 0.001). From 1987, 34 adults patients with human immunodeficiency virus (HIV) infection developed salmonellosis. The infection was due to Salmonella serogroup B (29.4%) and the extraintestinal manifestations (58.8%) were most frequent in HIV-infected patients than in the control-group (p = 0.004 and p < 0.001, respectively). Salmonella serogroup D was identified in 1041 (71.2%) episodes, and serogroup B in 259 (17.7%). Salmonella serogroup B and C were more resistant to one or more antibiotics than Salmonella serogroup D (p = 0.001). Resistance of NTS (principally Salmonella serogroup B) for one or more antibiotics (particularly ampicillin and chloramphenicol) increased significantly during the period of study (p < 0.001).

CONCLUSIONS

The HIV-infected patients had a predisposition to develop extraintestinal Salmonella infections. Resistance of NTS for antibiotics, especially Salmonella serogroup B, has significantly increased during the last years.

背景

本研究旨在描述马德里大都市区一家综合医院非伤寒沙门氏菌病的流行病学特征。

方法

对1980年5月至1994年12月在希门尼斯·迪亚斯基金会微生物科诊断的非伤寒沙门氏菌病进行描述性回顾性研究。

结果

在1463例患者的1796份标本中鉴定出非伤寒沙门氏菌（NTS），其中520例（35.5%）年龄在15岁以下，943例（64.5%）年龄在14岁以上。1288例（88%）感染为肠道感染，129例（8.8%）为菌血症，46例（3.1%）为局灶性感染。肠外感染在14岁以上患者中最为常见（15.5%对5.6%；p<0.001）。从1987年起，34例成人人类免疫缺陷病毒（HIV）感染患者发生沙门氏菌病。感染由B血清群沙门氏菌引起（29.4%），HIV感染患者的肠外表现（58.8%）比对照组更常见（分别为p = 0.004和p<0.001）。在1041例（71.2%）病例中鉴定出D血清群沙门氏菌，259例（17.7%）为B血清群沙门氏菌。B和C血清群沙门氏菌比D血清群沙门氏菌对一种或多种抗生素的耐药性更强（p = 0.001）。在研究期间，NTS（主要是B血清群沙门氏菌）对一种或多种抗生素（特别是氨苄西林和氯霉素）的耐药性显著增加（p<0.001）。