摘要
目的探讨沙门菌感染急性腹泻患儿治疗预后及危险因素。方法回顾性分析2015年8月至2017年7月期间于湖北文理学院附属医院儿科与湖北省妇幼保健院儿科住院确诊并接受治疗的1 216例细菌性感染急性腹泻患儿,采集患儿粪便样本进行细菌分离培养鉴定致病菌类型,采用Kirby-Bauer纸片法进行药敏试验。所有患儿进行对症治疗和抗感染治疗,分析患儿治疗结果以及沙门菌感染和预后危险因素。结果采集患儿粪便1 216份,检出71株(5.84%)沙门菌。患儿年龄越小、家庭经济条件越差、住院时间越长、农村患儿、接受侵入性操作等感染沙门菌的几率越高(P<0.05)。治疗后总有效率为94.37%。经药敏试验结果显示,沙门菌对头孢唑林、氨苄西林、哌拉西林耐药率最高,依次为81.69%、60.56%、59.15%;对美罗培南和左氧氟沙星耐药率最低,分别为1.41%和12.68%。城镇、家庭收入水平较高、住院时间短的患儿沙门菌抗感染治疗的有效率较高,差异有统计学意义(P<0.05)。结论患儿家庭条件、经济收入、家长的卫生习惯、住院时间以及侵入性操作等是沙门菌感染的独立危险因素。患儿家庭状况和住院时间同时也是沙门菌感染预后的独立危险因素。
Objective To discuss the risk factors of Salmonella infection in children with acute bacterial diarrhea.Methods 1 216 children patients with acute bacterial diarrhea in Pediatrics Department of Affiliated Hospital of Hubei Academy of Arts and Sciences and Pediatrics Department of Hubei Maternal and Child Health Hospital from October 2015 to July 2017 were analyzed.The faecal samples of patients were collected and detected by culture isolation method.Antimicrobial susceptibility was tested by the Kirby-Bauer method.All patients were treated with symptomatic and antiinfection treatment.The clinical outcomes and risk factors were analyzed.Results There were 71 specimens with Salmonella in 1 216 feacal samples(5.84%).The younger patients,the poor family condition,in the villages,with invasive operation and longer hospital stays had higher incidence of Salmonella infection(P<0.05).After treatment,the total effect rate was 94.37%.The results of the drug sensitivity test showed that Salmonella had the highest resistance rates to cefazolin,ampicillin,and piperacillin(81.69%,60.56%,and 59.15%,respectively);the resistance rates to meropenem and levofloxacin were the lowest(1.41% and 12.68%,respectively).The effective rates of Salmonella anti-infective treatment in children with higher income levels,shorter hospital stays and living in cities and towns were significantly higher than those with lower income levels,longer hospital stays and living in villages(P<0.05).Conclusions Salmonella was the dominant pathogenic bacterium associated with the family condition,health habit,hospital stay and invasive operation.Besides,the family condition and hospital stay of children patients could be the risk factors of prognosis.
作者
黄方
姜勇超
王丽
涂丹娜
陈霞
HUANG Fang;JIANG Yong-chao;WANG Li;TU Dan-na;CHEN Xia(Affiliated Hospital of Hubei Academy of Arts and Sciences,Pediatrics Department of Xiangyang Central Hospital,Xiangyang,Hubei 441021;Department of Pediatrics,Hubei Maternal and Child Health Hospital,Wuhan,Hubei 437600,China)
出处
《热带医学杂志》
CAS
2020年第9期1236-1239,共4页
Journal of Tropical Medicine
关键词
沙门菌
急性腹泻
危险因素
Salmonella
Acute diarrhea
Risk factors
