奥雷宁堡沙门菌致儿童血流感染1例
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摘要
目的分析1例奥雷宁堡沙门菌致儿童血流感染的临床特点、药敏结果并复习文献,旨在提高对侵袭性非伤寒沙门菌致血流感染的认识和抗菌药物的选择。方法报道1例腹泻并发热低龄患儿血培养检出奥雷宁堡沙门菌的病例。结果该患者的一套血培养均培养出奥雷宁堡沙门菌,该菌对临床常用抗菌药物敏感,选用阿莫西林/舒巴坦治疗有效。结论低龄患儿因无法准确描述病情,对于疑似血流感染的病例应积极寻找病原菌,抗生素使用前及时送检血培养,同时在治疗过程中关注病原菌药敏结果的变化避免复发。
Objective To explore the clinical characteristics of a case of bloodstream infections in children caused by Orenenberg salmonella, to analyze the antimicrobial susceptibility of Salmonella oranienburg which was obtained from the patient's blood sample, and to review relevant literatures retrospectively. Then to improve the understanding and the selection of antimicrobial in bloodstream infections caused by invasive non-typhoid Salmonella. Methods A case of sepsis with Orenenberg salmonella in a child with the complications of diarrhea and fever was reported, and the clinical characteristics were retrospectively analyzed. Results A set of blood cultures of the patient showed Gram-negative-bacilli, and the isolate was distinctly identified as Salmonella oranienburg. The strain was sensitive to the commonly used antibiotics, and the patient was cured by the treatment using amoxicillin/sulbatartan. Conclusion Young children cannot accurately describe their symptoms. Doctors should look for the pathogens actively for the suspected cases of bloodstream infections, and the blood cultures should be tested before antibiotics are used. In addition, attentions have to be paid to the change of the antimicrobial susceptibility in the treatment to avoid recurrence.
Objective To explore the clinical characteristics of a case of bloodstream infections in children caused by Orenenberg salmonella, to analyze the antimicrobial susceptibility of Salmonella oranienburg which was obtained from the patient's blood sample, and to review relevant literatures retrospectively. Then to improve the understanding and the selection of antimicrobial in bloodstream infections caused by invasive non-typhoid Salmonella. Methods A case of sepsis with Orenenberg salmonella in a child with the complications of diarrhea and fever was reported, and the clinical characteristics were retrospectively analyzed. Results A set of blood cultures of the patient showed Gram-negative-bacilli, and the isolate was distinctly identified as Salmonella oranienburg. The strain was sensitive to the commonly used antibiotics, and the patient was cured by the treatment using amoxicillin/sulbatartan. Conclusion Young children cannot accurately describe their symptoms. Doctors should look for the pathogens actively for the suspected cases of bloodstream infections, and the blood cultures should be tested before antibiotics are used. In addition, attentions have to be paid to the change of the antimicrobial susceptibility in the treatment to avoid recurrence.
引文
[1]毛雪丹,胡俊峰,刘秀梅.用文献综述法估计我国食源性非伤寒沙门氏菌病疾病负担[J].中华疾病控制杂志,2011,15(7):622-625.
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[5]师伟,夏琳林,刘晓霞,等.临床分离非伤寒沙门菌耐药性及对头孢曲松耐药机制[J].中国感染控制杂志,2016,15(4):217-221.
[6]Clinical and Laboratory Standards Institute.Performance standards for antimicrobial susceptibility testing,twentythree informational supplement[S].CLSI document,Ml00-S23,2013.
[7]余晓君,陈强,陈冲,等.鼠伤寒沙门菌临床分离株对喹诺酮类药物耐药机制的研究[J].中华医院感染学杂志,2012,22(14):2982-2985.
[8]吴伟元,王辉,陆坚,等.深圳社区感染沙门菌耐药基因调查与同源性分析[J].中华检验医学杂志,2011,34(5):431-436.
[9]胡付品,朱德妹,汪复,等.2014年CHINET中国细菌耐药性监测[J].中国感染与化疗杂志,2015,15(5):401-410.
[10]Yang W C,Chan O W,Wu T L,et al.Development of ceftriaxone resistance in Salmonella enterica serotype Oranienburg during therapy for bacteremia[J].J Microbiol Immunol Infect,2016,49(1):41-45.
[11]白书媛,张浩,王培昌,等.淋巴瘤患者血中分离出奥雷宁堡沙门菌1例[J].临床检验杂志,2012,30(9):718-718.
[2]郭益群,王鹏,杨春霞,等.成人侵袭性沙门菌属感染23例临床分析[J].首都医科大学学报,2017,38(5):744-748.
[3]Marzel A,Desai P T,Nissan I,et al.Integrative analysis of Salmonellosis in Israel reveals association of Salmonella enterica Serovar 9,12:l,v:-with extraintestinal infections,dissemination of endemic S.enterica serovar typhimurium DT104 biotypes,and severe underreporting of outbreaks[J].J Clin Microbiol,2014,52(6):2078-2088.
[4]Phoba M F,Boeck H D,Ifeka B B,et al.Epidemic increase in Salmonella,bloodstream infection in children,Bwamanda,the democratic republic of congo[J].Eur J Clin Microbiol Infect Dis,2014,33(1):79-87.
[5]师伟,夏琳林,刘晓霞,等.临床分离非伤寒沙门菌耐药性及对头孢曲松耐药机制[J].中国感染控制杂志,2016,15(4):217-221.
[6]Clinical and Laboratory Standards Institute.Performance standards for antimicrobial susceptibility testing,twentythree informational supplement[S].CLSI document,Ml00-S23,2013.
[7]余晓君,陈强,陈冲,等.鼠伤寒沙门菌临床分离株对喹诺酮类药物耐药机制的研究[J].中华医院感染学杂志,2012,22(14):2982-2985.
[8]吴伟元,王辉,陆坚,等.深圳社区感染沙门菌耐药基因调查与同源性分析[J].中华检验医学杂志,2011,34(5):431-436.
[9]胡付品,朱德妹,汪复,等.2014年CHINET中国细菌耐药性监测[J].中国感染与化疗杂志,2015,15(5):401-410.
[10]Yang W C,Chan O W,Wu T L,et al.Development of ceftriaxone resistance in Salmonella enterica serotype Oranienburg during therapy for bacteremia[J].J Microbiol Immunol Infect,2016,49(1):41-45.
[11]白书媛,张浩,王培昌,等.淋巴瘤患者血中分离出奥雷宁堡沙门菌1例[J].临床检验杂志,2012,30(9):718-718.