Dual-center study of the clinical and microbiological characteristics of invasive Salmonella infection in children in Zhejiang Province
10.3760/cma.j.cn311365-20240709-00201
- VernacularTitle:浙江省儿童侵袭性沙门菌感染临床和微生物学特点的双中心研究
- Author:
Longhui SHEN
1
;
Chenggang LU
;
Chunzhen HUA
;
Juanfei HE
;
Qiaoer LUO
Author Information
1. 宁波大学附属妇女儿童医院药剂科，宁波 315010
- Publication Type:Journal Article
- Keywords:
Children;
Salmonella;
Invasive infection;
Antibiotic resistance;
Serotype
- From:
Chinese Journal of Infectious Diseases
2024;42(9):538-543
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the clinical and microbiological characteristics of invasive Salmonella infection in children. Methods:Clinical data of children with invasive Salmonella infection diagnosed in the Children′s Hospital Zhejiang University School of Medicine and Women and Children′s Hospital of Ningbo University from January 2018 to June 2022 were retrospectively analyzed, and the serotypes and drug resistance of the pathogens were detected. The chi-square test was used to compare the resistance rates of different Salmonella serogroups to antibiotics. Results:A total of 105 invasive Salmonella infection cases were included, with ages of 20.0 (12.3, 43.5) months, and 67 cases(63.8%)were male. Fifty-seven cases occurred in summer (from June to August). Eighty-seven cases were confirmed by blood culture, 10 cases by bone marrow or bone marrow cavity pus culture, six cases by cerebrospinal fluid and other specimen culture, with an additional two cases where Salmonella was cultured from two types of specimens including blood, bone marrow or cerebrospinal fluid. Thirty-six patients had underlying diseases, of which 58.3%(21/36) were leukemia. The resistance rates of the strains to ampicillin, ceftriaxone, ceftazidime, piperacillin-tazobactam, imipenem, and trimethoprim-sulfamethoxazole were 48.5%(51/105), 12.3%(13/105), 9.5%(10/105), 1.9%(2/105), 0(0/105), and 29.5%(31/105), respectively. Ninety-nine strains (94.3%) belonged to invasive non-typhoidal Salmonella (iNTS), four strains were Salmonella typhi, and 13 strains were Salmonella typhimurium. The resistance rate of group D strains to ceftriaxone was lower than that of group B ( χ2=5.38, P=0.020) and group E ( χ2=5.74, P=0.017). The resistance rate of group D strains to trimethoprim-sulfamethoxazole was lower than that of group C ( χ2=5.67, P=0.017), group B ( χ2=13.02, P<0.001) and group E ( χ2=9.00, P=0.003), and the differences were all statistically significant. The symptoms of fever and diarrhea accounted for 94.3%(99/105) and 51.4%(54/105), respectively. The most common diagnosis was septicemia, accounting for 88.6%(93/105), pyogenic osteomyelitis with pyogenic arthritis accounted for 10.5%(11/105), and four patients (3.8%) developed purulent meningitis. All 105 patients received antibiotic treatment, 101 patients (96.2%) were cured or improved, and four cases (3.8%) died. Conclusions:iNTS infection is more common than typhoid fever in children. Different serotypes of strains have different resistance to antimicrobial drugs. Invasive strains such as bloodstream are more sensitive to the third-generation cephalosporin. The third-generation cephalosporin is still the first choice for the treatment of iNTS diseases.
