Extraintestinal Salmonellosis in a General Hospital (1991 to 1996): Relationships between Salmonella Genomic Groups and Clinical Presentations
Extraintestinal Salmonellosis in a General Hospital (1991 to 1996): Relationships between Salmonella Genomic Groups and Clinical Presentations
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综合医院的肠外沙门氏菌病（1991 年至 1996 年）：沙门氏菌基因组群与临床表现之间的关系
DOI：
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发表时间：
1998
影响因子：
9.4
通讯作者：
M. Mendoza
中科院分区：
文献类型：
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作者：
Mercedes Rodríguez;I. de Diego;M. Mendoza
通过分析沙门氏菌生物体的表型和基因型特征以及来自医学报告的临床数据，对一家综合医院（1，522张病床）在6年期间（1991年至1996年）治疗的肠外沙门氏菌病的流行进行了表征。肠外沙门氏菌病占所有沙门氏菌病发作的8%。本文回顾了52份医学报告，其中伤寒6例，菌血症32例，局灶性感染14例。除1例、7例菌血症和5例局灶性感染外，所有伤寒病例均与任何基础疾病或诱发因素无关，而25例菌血症和9例局灶性感染与其中一些危险因素有关。所有伤寒菌株和65.4%的非伤寒菌株对抗菌药物敏感。51个非伤寒菌株进行了分析，并分配到21个基因组，这是定义的血清型，结合核糖体型，并结合随机扩增多态性DNA类型（每个基因组可能包括生物体在一些表型性状不同）。基因组和临床表现之间的关系进行了跟踪。引起22次发作的微生物（17次菌血症、2次肺炎、1次腹膜炎、1次肾盂肾炎和1次膀胱炎）属于流行的肠道沙门氏菌血清型肠道沙门氏菌基因组群，其中包括分配给4种噬菌体类型、5种生物型和4种耐药模式的微生物，引起有和无风险因素的患者感染。其他7个基因组群，4个肠杆菌群（与菌血症和局灶性感染相关）、2个鼠伤寒群（一个与菌血症相关，另一个与局灶性感染相关）和1个勃兰登堡群（与菌血症相关）包括两种或更多种菌株，其余13个基因组群各仅由一种菌株组成。
ABSTRACT Episodes of extraintestinal salmonellosis treated at a general hospital (1,522 beds) over a 6-year period (1991 to 1996) were characterized by the analysis of phenotypic and genotypic traits of Salmonella organisms and clinical data from medical reports. Extraintestinal salmonellosis accounted for 8% of all salmonellosis episodes. Fifty-two medical reports, dealing with 6 cases of typhoid fever, 32 cases of bacteremia, and 14 focal infections, were reviewed. All cases of typhoid fever except 1, 7 cases of bacteremia, and 5 focal infections were not related to any underlying disease or predisposing factors, while 25 cases of bacteremia and 9 focal infections were associated with some of these risk factors. All typhoid isolates and 65.4% of the nontyphoid isolates were susceptible to antimicrobials. Fifty-one nontyphoid strains were analyzed and assigned to 21 genomic groups, which were defined by serotype, combined ribotype, and combined randomly amplified polymorphic DNA type (each genomic group could include organisms differing in some phenotypic traits). The relationships between genomic groups and clinical presentations were traced. Organisms causing 22 episodes (17 episodes of bacteremia, 2 of pneumonia, 1 of peritonitis, 1 of pyelonephritis, and 1 of cystitis) belonged to a prevalent Salmonella enterica serotype Enteritidis genomic group, which included organisms assigned to four phage types, five biotypes, and four resistance patterns, causing infections in patients with and without risk factors. Seven other genomic groups, 4 Enteritidis groups (associated with both bacteremia and focal infections), 2 Typhimurium groups (one associated with bacteremia and the other with focal infections) and 1 Brandenburg group (associated with bacteremia) included two or more strains, and the remaining 13 genomic groups consisted of only one strain each.