Prevalence Characteristics And Drug Resistance Analysis Of Nontyphoid Salmonella Infections Among Children In A Hospital In Anhui Province From 2016 To 2022

Objective To study the clinical manifestations,epidemiological characteristics and drug resistance of children with nontyphoidal Salmonella infections in a region of Anhui Province from 2016-2022.Methods Case data including epidemiological data(time of onset,age and sex),clinical presentation(abdominal pain,fever,vomiting,stool properties,presence of blood in the eyes),laboratory results(blood routine,biochemistry,stool routine,stool culture and drug sensitivity analysis,blood culture and drug sensitivity analysis,cerebrospinal fluid culture and drug sensitivity analysis).Results Clinical data were collected from 111 children with nontyphoid Salmonella infections.51.4% were aged 0-1 year(including 1 year),with the largest number of admissions at July,August and September,accounting for 14.4%,22.5% and 16.2%respectively.A total of 19 serotypes were detected,38 cases(34.2%)were Salmonella Typhimurium,20 cases(18.0%)were Salmonella Enteritidis and 5 cases(4.5%)were Salmonella Newport.10.8% of the children had no abdominal pain,only 20% were dehydrated,only 19.8% vomited and only 3 cases had normal stool characteristics.Faecal occult blood was positive in 72 cases(64.9%)and negative in 39 cases(35.1%).104 cases were non-invasive nontyphoid Salmonella infections(93.7%)and only 7cases were invasive nontyphoid Salmonella infections(1 case with positive cerebrospinal fluid culture alone and 6 cases with positive blood culture alone).A total of 63(56.8%)nontyphoid Salmonella strains were isolated as multi-resistant to antibiotics,with the highest overall resistance rate of 82.9% to gentamicin,82.0% to amikacin and ampicillin,80.2% to tobramycin,46.8% to cotrimoxazole,27.9% to ciprofloxacin,and cephalexin curve with an overall resistance rate of 24.3%,amineptine with an overall resistance rate of 22.5%,ceftazidime with an overall resistance rate of 21.6%,levofloxacin with an overall resistance rate of 13.5%,piperacillin/tazobactam with an overall resistance rate of 9.9%,ertapenem with an overall resistance rate of 2.7% and imipenem with the lowest overall resistance rate of0%.The percentage of multi-drug resistant nontyphoid Salmonella was increasing year on year from 2016-2021,decreasing in 2022.The resistances of ciprofloxacin,levofloxacin,amikacin,gentamicin and tobramycin were elevated in the 2020-2022 phase relative to 2016-2018,with statistically significant differences.In the comparison between Salmonella Typhimurium and Salmonella Enteritidis,the resistance to ciprofloxacin,tobramycin and cotrimoxazole was much greater in Salmonella Typhimurium than in Salmonella Enteritidis,while resistance to ampicillin,piperacillin/tazobactam,ceftazidime,ceftriaxone,aminotransomide,imipenem,ertapenem,amikacin and gentamicin was not significantly different between the two.Conclusion In 2016-2022,the serotypes of nontyphoid Salmonella infections in a region of Anhui Province were dominated by Salmonella Typhimurium and Salmonella Enteritidis.Children under 5 years of age were more common,more boys than girls,and more frequent in summer and autumn.Isolated nontyphoid Salmonella strains were least resistant to imipenem and most resistant to gentamicin.There is an increasing trend in the emergence of multi-resistant nontyphoid Salmonella.Clinical suspicion of nontyphoid Salmonella infection requires prompt stool culture and drug sensitivity testing,and imipenem is preferred for children with treatment-indicated nontyphoid Salmonella infections where drug sensitivity testing is unknown.