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Purpose  To investigate the characteristics of gastrointestinal infections in Southwest Shanghai.    Methods  Clinical and epidemiological characteristics of patients with  Salmonella  infections between 1998 and 2017 admitted to the Jinshan Hospital in the Southwest of Shanghai were retrospectively analyzed. A total of 565 isolated  Salmonella  strains were classified by serotyping and pulsed field gel electrophoresis (PFGE).    Results  From 1998 to 2006, diarrhea was mainly caused by  Vibrio parahaemolyticus  followed by  Shigella  and  Salmonella . From 2007 to 2010,  Vibrio parahaemolyticus  infection was the major cause of diarrhea followed by  Salmonella  and  Shigella . From 2011 to 2017,  Salmonella  infections became the main cause of diarrhea after  Vibrio parahaemolyticus .  Salmonella  infections increased from 2006 on and peaked between May and October, accounting for 82.48% of yearly infections. Patients with  Salmonella  infections (90.5%) had a history of eating unclean food, abdominal pain (58.05%), diarrhea ≥5 times a day (50.44%), moderate fever (24.96%) and increased fecal leukocytes (41.42%). From 1998 to 2017, infected specimens from clinical cases were dominated by  Salmonella enterica  serovar Typhimurium ( S . Typhimurium) (21.59%) followed by  Salmonella enterica  serovar Enteritis ( S . Enteritidis) (16.81%),  Salmonella enterica  serotype London (6.55%) and  Salmonella  group B (13.10%). Other species included  Salmonella enterica  serovar Thompson,  Salmonella enterica  serovar Saintpaul,  Salmonella  group D,  Salmonella  group C,  Salmonella enterica  serovar Choleraesuis and  Salmonella enterica  serovar Aberdeen. The PFGE classification of  Salmonella  serovars in 2008–2017 demonstrated that  S . Enteritidis had 9 PFGE banding patterns and  S . Typhimurium 16 with varying degrees of similarity among  S . Enteritidis and  S . Typhimurium. The results of antibiotic susceptibility tests for the 330  Salmonella  strains revealed that fosfomycin had the highest sensitivity rate (97.5%) followed by levofloxacin and ceftriaxone (81%), and ampicillin/sulbactam (78.2%). The resistance to piperacillin and ciprofloxacin was 60.9 and 50.61%, respectively.    Conclusion  The features of onset, epidemiological characteristics and molecular subtyping of  Salmonella  were conducive to clinical diagnosis, rational use of antibiotics and improved therapeutic efficacy.

Epidemiological and Molecular Investigations on Salmonella Responsible for Gastrointestinal Infections in the Southwest of Shanghai From 1998 to 2017