肺炎链球菌感染相关性儿童化脓性脑膜炎临床特征研究  

Clinical features of Streptococcus pneumoniae infection in children with purulent meningitis

作　　者：王秀锋[1] 孙瑞雪[1] 付琳[2] 王芳[1] 张艳玲[1] 

机构地区：[1]河北医科大学附属邢台市人民医院儿三科,河北邢台054000 [2]河北医科大学附属邢台市人民医院病理科,河北邢台054000

出　　处：《中华医院感染学杂志》2016年第18期4222-4224,共3页Chinese Journal of Nosocomiology

基　　金：河北省卫生厅医学科研基金资助项目(20134507);河北省邢台市科技计划支撑基金资助项目(2015ZC081)

摘　　要：目的研究儿童化脓性脑膜炎肺炎链球菌感染临床感染特征及耐药性,为提高临床治疗效果提供依据。方法选取2014年10月-2015年10月诊治的38例肺炎链球菌感染化脓性脑膜炎患儿临床资料和患儿留取的血液、脑脊液、痰液等标本病原菌耐药性进行分析。结果 38例患儿共分离肺炎链球菌38株,菌株来源以血液、脑脊液为主,分别占60.53%和28.95%;肺炎链球菌感染相关性儿童化脓性脑膜炎多发于男性,年龄<2岁,以春、冬季为主;同时,肺炎链球菌感染相关性儿童化脓性脑膜炎在脓毒血症和无基础疾病中患儿中发生率高,且多数患儿为社区获得;肺炎链球菌对青霉素、左氧氟沙星以及利福平耐药率为0,对红霉素、克林霉素耐药率较高。结论肺炎链球菌感染相关性儿童化脓性脑膜炎在5岁以内儿童中发生率较高,患儿以脓毒血症、化脓性脑膜炎等为主,应加强患儿病原菌培养与药敏试验,选择敏感性高的抗菌药物治疗。OBJECTIVE To explore the clinical features of Streptococcus pneumoniae infection in children with purulent meningitis and analyze the drug resistance so as to improve the clinical therapeutic effect.METHODS The clinical data were collected from 38 purulent meningitis children complicated with S.pneumoniae infection who were treated in the hospital from Oct 2014 to Oct 2015.The blood,cerebrospinal fluid,and sputum specimens that were obtained from the children were cultured,and the drug resistance of the isolated pathogens was observed.RESULTS A total of 38 strains of S.pneumoniae were isolated from the 38 children,of which 60.53% were isolated from the blood specimens,and 28.95% were isolated from the cerebrospinal fluid specimens.The S.pneumoniaeinfection-associated purulent meningitis tended to occur in the male children with less than 2years of age,and the spring and winter were the peak seasons.The incidence of S.pneumoniae infection-associated purulent meningitis was high in the children with sepsis or the children without underlying diseases,and the community-acquired S.pneumoniaeinfection was dominant.The drug resistance rates of the S.pneumoniaeto penicillin,levofloxacin,and rifampicin were 0;however,the drug resistance rates to erythromycin and clindamycin were high.CONCLUSIONThe incidence of S.pneumoniaeinfection-associated purulent meningitis is high among the children aged less than 5years old,and the children with sepsis or purulent meningitis are dominant.It is necessary to strengthen the culture of pathogens and drug susceptibility testing for the children and choose sensitive antibiotics for treatment.

关 键 词：肺炎链球菌 儿童 化脓性脑膜炎 临床特征 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]