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首页> 外文期刊>Transactions of the Royal Society of Tropical Medicine and Hygiene >Enteric fever in Cambodian children is dominated by multidrug-resistant H58 Salmonella enterica serovar Typhi with intermediate susceptibility to ciprofloxacin
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Enteric fever in Cambodian children is dominated by multidrug-resistant H58 Salmonella enterica serovar Typhi with intermediate susceptibility to ciprofloxacin

机译：柬埔寨儿童的肠热主要由耐多药性H58肠炎沙门氏菌伤寒沙门氏菌为主，对环丙沙星的敏感性中等

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摘要

Infections with Salmonella enterica serovar Typhi isolates that are multidrug resistant (MDR: resistant to chloramphenicol, ampicillin, trimethoprim-sulphamethoxazole) with intermediate ciprofloxacin susceptibility are widespread in Asia but there is little information from Cambodia. We studied invasive salmonellosis in children at a paediatric hospital in Siem Reap, Cambodia. Between 2007 and 2011 Salmonella was isolated from a blood culture in 162 children. There were 151 children with enteric fever, including 148 serovar Typhi and three serovar Paratyphi A infections, and 11 children with a non-typhoidal Salmonella infection. Of the 148 serovar Typhi isolates 126 (85%) were MDR and 133 (90%) had intermediate ciprofloxacin susceptibility. Inpatient antimicrobial treatment was ceftriaxone alone or initial ceftriaxone followed by a step-down to oral ciprofloxacin or azithromycin. Complications developed in 37/128 (29%) children admitted with enteric fever and two (1.6%) died. There was one confirmed relapse. In a sample of 102 serovar Typhi strains genotyped by investigation of a subset of single nucleotide polymorphisms, 98 (96%) were the H58 haplotype, the majority of which had the common serine to phenylalanine substitution at codon 83 in the DNA gyrase. We conclude that antimicrobial-resistant enteric fever is common in Cambodian children and therapeutic options are limited.
机译：在亚洲广泛存在具有多药耐药性（耐多药（MDR：对氯霉素，氨苄青霉素，甲氧苄啶-磺胺甲恶唑的耐药性））的沙门氏菌血清型伤寒沙门氏菌的感染，但在柬埔寨却很少。我们在柬埔寨暹粒一家儿科医院研究了儿童侵袭性沙门氏菌病。在2007年至2011年之间，从162名儿童的血液培养物中分离出沙门氏菌。共有151例儿童发烧，其中包括148例Typhi血清型和3例副伤寒A型血清型感染，还有11例非伤寒沙门氏菌感染儿童。在148个血清型伤寒分离株中，有126个（85％）是MDR，有133个（90％）具有中等环丙沙星敏感性。住院患者的抗菌治疗为单独使用头孢曲松或初始头孢曲松，然后逐步降低口服环丙沙星或阿奇霉素。接受肠热的儿童中有37/128（29％）名儿童发生并发症，有2名（1.6％）死亡。确诊复发。在通过研究单核苷酸多态性子集对102个血清型鼠伤寒病毒菌株进行基因分型的样本中，有98个（96％）是H58单倍型，其中大多数在DNA促旋酶的第83位密码子上有丝氨酸到苯丙氨酸的共同取代。我们得出的结论是，柬埔寨儿童中常见的是抗药性肠热，而且治疗选择有限。

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