【用戶】最後一哩路加油
【年級】大二下
【評論內容】介紹一下沙門氏菌傷寒沙門氏菌、豬霍亂沙門氏菌、腸炎沙門氏桿菌、都柏林沙門氏菌(Sal. Dublin)臨床上常見的病原菌分為以下：傷寒沙門氏菌 (Salmonella typhi)、豬霍亂沙門氏菌 (Salmonella choleraesuis) 和腸炎沙門氏桿菌 (Salmonella enteritidis)、都柏林沙門氏菌(Sal. Dublin)。其中，腸炎沙門氏桿菌有超過 2,000 種的血清型，其命名係根據所造成的疾病。 沙門氏菌引起的感染症狀沙門氏菌腹瀉（腸胃炎） [diarrhea, gastroenteritis] 為沙門氏菌感染最常見的症狀，會由數百種血清型中的一種非傷寒沙門氏菌所所引起，約一百萬一千萬個細菌即可引發感染。在攝食污染食物後約 18 小時（8~24 小時）發病，因此亦稱為沙門氏菌食物中毒。症狀多為突然發作，包括下痢、發熱、腹痛、噁心、嘔吐、頭病、寒顫等，可在小腸和大腸形成發炎病灶。腹瀉通常以水瀉或較少見含有膿與少量血，約半數的病人會發燒。這種腹瀉由類似霍亂毒素的毒素所引起（水瀉），且有時亦由迴腸發炎引起黏膜腹瀉 (mucous diarrhea)。甚少出現菌血症（約 2~4%），除非在免疫缺乏病人，血液培養通常為陰性，而糞便培養常為陽性，並持續數星期。病程持續 2~3 天後可自行痊癒。最常引起此病者為腸炎沙門氏菌 (S. enteritidis serotype typhimurium) 又稱鼠傷寒桿菌 (S. typhimurium)。 沙門氏菌的感染途徑沙門氏菌帶菌者或無明顯症狀患者的糞便常為食品的污染源，若帶菌者為食品烹調者，常持續釋出沙門氏菌，因此，營養午餐供應廠家的廚師或供饍人員，應定期檢驗其糞便是否為沙門氏菌帶菌者。許多動物如牛、鼠、雞，常有各種沙門氏菌感染，因此肉類、蛋、動物排泄物常有沙門氏菌存在。感染來源主要為受污染的食品和飲料，包括飲用水、乳製品、海鮮、蛋、肉品、家庭寵物（如貓、狗、小烏龜）等。
【用戶】吳富豪
【年級】高三下
【評論內容】Nontyphoidal Salmonella:Gastrointestinal infection and asymptomatic carriage(S. typhimurium S. enteritidis S. dublin S. choleraesuis) Nonpregnant adults and adolescentsOral therapyFluoroquinolones (eg, ciprofloxacin 500 mg orally twice daily or levofloxacin 500 mg orally once daily) are preferred (in the absence of contraindications) because of their activity against most common gram-negative enteric pathogens, their high tissue and intracellular concentrations, and their favorable side effect profile其他替代Trimethoprim-sulfamethoxazole (160 mg/800 mg orally twice daily)Cefixime (400 mg orally once or twice daily)Azithromycin (1 gram, followed by 500 mg daily for five to seven days). It should be noted that antimicrobial resistance testing of Salmonellae for azithromycin susceptibility is not standardized and may not be performed by many laboratories.High-dose amoxicillin (75 to 100 mg/kg per day)Parenteral therapy For patients with severe disease who cannot tolerate oral therapy, an intravenous fluoroquinolone or a third-generation cephalosporin (eg, ceftriaxone 1 to 2 g intravenously once daily or cefotaxime 2 g intravenously every eight hours) 複雜性與非複雜性 (太複雜了，還有以區域劃分的>< 給連結+簡單分類 )(typhoid and paratyphoid)Severe or complicated diseaseInfection acquired outside Pakistan or IraqInfection acquired in Pakistan or IraqUncomplicated diseaseFluoroquinolones (ciprofloxacin or ofloxacin)infections acquired in South Asia or other areas with a high risk of reduced susceptibility to fluoroquinolones (eg, nalidixic acid resistance), we suggest azithromycinhttps://www-uptodate-com.autorpa.ndmctsgh.edu.tw/contents/nontyphoidal-salmonella-gastrointestinal-infection-and-asymptomatic-carriage?search=Nontyphoidal%20Salmonella&topicRef=3126&source=see_link#H1058721980
【用戶】多倫多多
【年級】大一上
【評論內容】sulfamethoxazole / trimethoprim（400 / 80 mg/tablet）劑量太小Intestinal salmonellosis severe enough to require hospitalization腸道沙門氏菌病嚴重到需要住院治療sulfamethoxazole / trimethoprim（來源 Micromedex ®）成人：1 double-strength tablet (160 mg trimethoprim/800 mg sulfamethoxazole) 口服，ＢＩＤ for 5 to 7 days (10 to 14 days for bacteremic salmonellosis)小兒：5 mg/kg 口服，ＢＩＤ for 5 to 7 days
【用戶】IG:Pharmabook
【年級】高一上
【評論內容】(A)選項解題+補充Applied統整內文salmonella分成兩種類型Non-typhoidal salmonellaSalmonella typhimurium, Salmonella enteritidis (A)Salmonella dublin (B)Salmonella choleraesuis (C)腸胃炎 (gastroenteritis) 菌血症局部感染首選FQ、Azithromycin三代cephalosporin替代：Amoxicillin、TMP-SMXTyphoidal salmonellaSalmonella typhi (D) Salmonella paratyphi A, B, and Ctyphoid orparatyphoid feverchronic carriage首選FQ、Azithromycin三代cephalosporin替代：Amoxicillin、TMP-SMX (A)選項：Non-typhoidal salmonella引起的uncomplicated腸胃炎，通常2-5天會開始好轉，不建議使用抗生素若使用藥物反而讓病人有ADR或產生抗藥性風險→此時多補充水分及電解質即可!healthy individuals with uncomplicated non- typhoidal Salmonella gastroenteritis, antimicrobials are not recommended as salmonellosis is typically a self-limiting illness lasting for 2 to 5 daysAntimicrobials do not reduce the duration or severity of illness and may be harmful, by placing patients at risk for adverse drug reactions, prolonging the asymptomatic carriage of salmonellae, and promoting theemergence of antimicrobial-resistant bacteria Most individuals like B.B. will only require replacement of lost fluids and electrolytes -------------------------------------------------------------------------------------------------------------------抗生素的使用適用於會發生腸胃道外沙門氏桿菌感染風險的患者EX：癌症(C)、DM (B)、風濕病、HIV、服用免疫抑制劑使用的抗生素包括FQ (levofloxacin 500 mg QD)(B)、Azithromycin 500mg QD三代Cephalosporin (IV ceftriaxone 1-2g、cefotaxime 1 g IV Q8H (C)) Antimicrobials are indicated for patients at risk for developing extraintestinal Salmonella infection such as persons with malignancy (like W.M.), diabetes, rheumatologic disorders, HIV infection, persons receiving immunosuppressive therapiesoral fluoroquinolone (e.g., levofloxacin 500 mg once daily) for 7 to 10 days, azithromycin 500 mg once daily for 7 days, or parenteral ceftriaxone 1 to 2 grams daily 、cefotaxime 1g Q8H for 7 to 10 days ----------------------------------------------------------------------------------------------------------- (D)Salmonella typhi引起的uncomplicated腸胃炎 可使用FQ (Levofloxacin 500mg QD / Ciprofloxacin 500mg BID)Uncomplicated typhoid fever is typically treated in the outpatient setting.Empiric oral regimens include azithromycin 500 mg daily × 5 to 7 days, or a fluoroquinolone (e.g., levofloxacin 500 mg once daily or ciprofloxacin 500 mg twice daily).REF：11th Applied
【用戶】最後一哩路加油
【年級】大二下
【評論內容】介紹一下沙門氏菌傷寒沙門氏菌、豬霍亂沙門氏菌、腸炎沙門氏桿菌、都柏林沙門氏菌(Sal. Dublin)臨床上常見的病原菌分為以下：傷寒沙門氏菌 (Salmonella typhi)、豬霍亂沙門氏菌 (Salmonella choleraesuis) 和腸炎沙門氏桿菌 (Salmonella enteritidis)、都柏林沙門氏菌(Sal. Dublin)。其中，腸炎沙門氏桿菌有超過 2,000 種的血清型，其命名係根據所造成的疾病。 沙門氏菌引起的感染症狀沙門氏菌腹瀉（腸胃炎） [diarrhea, gastroenteritis] 為沙門氏菌感染最常見的症狀，會由數百種血清型中的一種非傷寒沙門氏菌所所引起，約一百萬一千萬個細菌即可引發感染。在攝食污染食物後約 18 小時（8~24 小時）發病，因此亦稱為沙門氏菌食物中毒。症狀多為突然發作，包括下痢、發熱、腹痛、噁心、嘔吐、頭病、寒顫等，可在小腸和大腸形成發炎病灶。腹瀉通常以水瀉或較少見含有膿與少量血，約半數的病人會發燒。這種腹瀉由類似霍亂毒素的毒素所引起（水瀉），且有時亦由迴腸發炎引起黏膜腹瀉 (mucous diarrhea)。甚少出現菌血症（約 2~4%），除非在免疫缺乏病人，血液培養通常為陰性，而糞便培養常為陽性，並持續數星期。病程持續 2~3 天後可自行痊癒。最常引起此病者為腸炎沙門氏菌 (S. enteritidis serotype typhimurium) 又稱鼠傷寒桿菌 (S. typhimurium)。 沙門氏菌的感染途徑沙門氏菌帶菌者或無明顯症狀患者的糞便常為食品的污染源，若帶菌者為食品烹調者，常持續釋出沙門氏菌，因此，營養午餐供應廠家的廚師或供饍人員，應定期檢驗其糞便是否為沙門氏菌帶菌者。許多動物如牛、鼠、雞，常有各種沙門氏菌感染，因此肉類、蛋、動物排泄物常有沙門氏菌存在。感染來源主要為受污染的食品和飲料，包括飲用水、乳製品、海鮮、蛋、肉品、家庭寵物（如貓、狗、小烏龜）等。
【用戶】多倫多多
【年級】大一上
【評論內容】sulfamethoxazole / trimethoprim（400 / 80 mg/tablet）劑量太小Intestinal salmonellosis severe enough to require hospitalization腸道沙門氏菌病嚴重到需要住院治療sulfamethoxazole / trimethoprim（來源 Micromedex ®）成人：1 double-strength tablet (160 mg trimethoprim/800 mg sulfamethoxazole) 口服，ＢＩＤ for 5 to 7 days (10 to 14 days for bacteremic salmonellosis)小兒：5 mg/kg 口服，ＢＩＤ for 5 to 7 days
【用戶】吳富豪
【年級】高三下
【評論內容】Nontyphoidal Salmonella:Gastrointestinal infection and asymptomatic carriage(S. typhimurium S. enteritidis S. dublin S. choleraesuis) Nonpregnant adults and adolescentsOral therapyFluoroquinolones (eg, ciprofloxacin 500 mg orally twice daily or levofloxacin 500 mg orally once daily) are preferred (in the absence of contraindications) because of their activity against most common gram-negative enteric pathogens, their high tissue and intracellular concentrations, and their favorable side effect profile其他替代Trimethoprim-sulfamethoxazole (160 mg/800 mg orally twice daily)Cefixime (400 mg orally once or twice daily)Azithromycin (1 gram, followed by 500 mg daily for five to seven days). It should be noted that antimicrobial resistance testing of Salmonellae for azithromycin susceptibility is not standardized and may not be performed by many laboratories.High-dose amoxicillin (75 to 100 mg/kg per day)Parenteral therapy For patients with severe disease who cannot tolerate oral therapy, an intravenous fluoroquinolone or a third-generation cephalosporin (eg, ceftriaxone 1 to 2 g intravenously once daily or cefotaxime 2 g intravenously every eight hours) 複雜性與非複雜性 (太複雜了，還有以區域劃分的>< 給連結+簡單分類 )(typhoid and paratyphoid)Severe or complicated diseaseInfection acquired outside Pakistan or IraqInfection acquired in Pakistan or IraqUncomplicated diseaseFluoroquinolones (ciprofloxacin or ofloxacin)infections acquired in South Asia or other areas with a high risk of reduced susceptibility to fluoroquinolones (eg, nalidixic acid resistance), we suggest azithromycinhttps://www-uptodate-com.autorpa.ndmctsgh.edu.tw/contents/nontyphoidal-salmonella-gastrointestinal-infection-and-asymptomatic-carriage?search=Nontyphoidal%20Salmonella&topicRef=3126&source=see_link#H1058721980
【用戶】IG:Pharmabook
【年級】高一上
【評論內容】(A)選項解題+補充Applied統整內文salmonella分成兩種類型Non-typhoidal salmonellaSalmonella typhimurium, Salmonella enteritidis (A)Salmonella dublin (B)Salmonella choleraesuis (C)腸胃炎 (gastroenteritis) 菌血症局部感染首選FQ、Azithromycin三代cephalosporin替代：Amoxicillin、TMP-SMXTyphoidal salmonellaSalmonella typhi (D) Salmonella paratyphi A, B, and Ctyphoid orparatyphoid feverchronic carriage首選FQ、Azithromycin三代cephalosporin替代：Amoxicillin、TMP-SMX (A)選項：Non-typhoidal salmonella引起的uncomplicated腸胃炎，通常2-5天會開始好轉，不建議使用抗生素若使用藥物反而讓病人有ADR或產生抗藥性風險→此時多補充水分及電解質即可!healthy individuals with uncomplicated non- typhoidal Salmonella gastroenteritis, antimicrobials are not recommended as salmonellosis is typically a self-limiting illness lasting for 2 to 5 daysAntimicrobials do not reduce the duration or severity of illness and may be harmful, by placing patients at risk for adverse drug reactions, prolonging the asymptomatic carriage of salmonellae, and promoting theemergence of antimicrobial-resistant bacteria Most individuals like B.B. will only require replacement of lost fluids and electrolytes -------------------------------------------------------------------------------------------------------------------抗生素的使用適用於會發生腸胃道外沙門氏桿菌感染風險的患者EX：癌症(C)、DM (B)、風濕病、HIV、服用免疫抑制劑使用的抗生素包括FQ (levofloxacin 500 mg QD)(B)、Azithromycin 500mg QD三代Cephalosporin (IV ceftriaxone 1-2g、cefotaxime 1 g IV Q8H (C)) Antimicrobials are indicated for patients at risk for developing extraintestinal Salmonella infection such as persons with malignancy (like W.M.), diabetes, rheumatologic disorders, HIV infection, persons receiving immunosuppressive therapiesoral fluoroquinolone (e.g., levofloxacin 500 mg once daily) for 7 to 10 days, azithromycin 500 mg once daily for 7 days, or parenteral ceftriaxone 1 to 2 grams daily 、cefotaxime 1g Q8H for 7 to 10 days ----------------------------------------------------------------------------------------------------------- (D)Salmonella typhi引起的uncomplicated腸胃炎 可使用FQ (Levofloxacin 500mg QD / Ciprofloxacin 500mg BID)Uncomplicated typhoid fever is typically treated in the outpatient setting.Empiric oral regimens include azithromycin 500 mg daily × 5 to 7 days, or a fluoroquinolone (e.g., levofloxacin 500 mg once daily or ciprofloxacin 500 mg twice daily).REF：11th Applied