某院60例化脓性脑膜炎患儿脑脊液标本中病原菌的分布与耐药性分析  

Analysis ofDistribution and Drug Resistance of Pathogenic Bacteria in Cerebrospinal Fluid Specimens of 60 Children with Purulent Meningitis in a Hospital

作　　者：张玉霞 ZHANG Yu-xia(Department of Pediatrics,Central Hospital,Jiaozuo Coal Industry(Group)Co.,Ltd.,Jiaozuo Henan 454000,China)

机构地区：[1]焦作煤业(集团)有限责任公司中央医院儿科,河南焦作454000

出　　处：《抗感染药学》2022年第3期341-344,共4页Anti-infection Pharmacy

摘　　要：目的:分析医院化脓性脑膜炎(purulent meningitis,PM)患儿脑脊液标本中病原菌的分布与耐药特点,为临床抗菌药物合理使用提供参考。方法:选取2018年7月—2020年6月焦作煤业(集团)有限责任公司中央医院收治的60例PM患儿的病历资料,分析不同年龄段患儿脑脊液标本中病原菌的分布及其耐药情况。结果:60例PM患儿脑脊液标本中共分离出121株致病菌,其中革兰阳性菌86株(占71.07%,以肺炎链球菌、表皮葡萄球菌和无乳链球菌为主)、革兰阴性菌35株(占28.92%,以大肠埃希菌为主),病原菌主要检出自<28日龄和28日龄~1岁的患儿;药敏结果显示,肺炎链球菌对莫西沙星和左氧氟沙星的耐药率均为0.00%,表皮葡萄球菌对环丙沙星、莫西沙星和左氧氟沙星的耐药率较低(<30.00%),无乳链球菌对苯唑西林、头孢呋辛、头孢噻肟的耐药率均为0.00%;大肠埃希菌对头孢替坦、头孢吡肟、亚胺培南、美罗培南、阿米卡星、妥布霉素、呋喃妥因的耐药率较低(≤20.00%)。结论:PM患儿脑脊液标本中病原菌主要为革兰阳性菌,但不同年龄段患儿病原菌的分布各有差异,临床应根据细菌培养和药敏试验结果合理选用抗菌药物,以保证抗感染治疗的疗效。Objective:To analyze distribution and drug resistance characteristics of pathogenic bacteria in cerebrospinal fluid specimens of children with purulent meningitis(PM)in a hospital,and provide reference for rational use of clinical antibacterial drugs.Methods:The medical records of 60 children with PM who were admitted to Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.from July 2018 to June 2020 were selected,and the distribution and drug resistance of pathogenic bacteria in cerebrospinal fluid specimens of children at different ages were analyzed.Results:A total of 121 pathogenic bacteria were isolated from the cerebrospinal fluid specimens of 60 children with PM,including 86 Gram-positive bacteria(71.07%,mainly Streptococcus pneumoniae,Staphylococcus epidermidis and Streptococcus agalactiae),35 Gram-negative bacteria(28.92%,mainly Escherichia coli),and the pathogenic bacteria were mainly detected in children less than 28 days old and those of 28 days old to 1 year old.The drug susceptibility results showed that the drug resistance rates of Streptococcus pneumoniae to moxifloxacin and levofloxacin were 0.00%,the drug resistance rates of Staphylococcus epidermidis to ciprofloxacin,moxifloxacin and levofloxacin were lower(<30.00%),and the drug resistance rates of Streptococcus agalactiae to oxacillin,cefuroxime,cefotaxime were 0.00%;the drug resistance rates of Escherichia coli to cefotetan,cefepime,imipenem,meropenem,amikacin,tobramycin,and nitrofurantoin were lower(≤20.00%).Conclusion:The pathogenic bacteria in the cerebrospinal fluid specimens of children with PM are mainly Gram-positive bacteria,but the distribution of pathogenic bacteria in children at different ages was different.Clinically,antibacterial drugs should be reasonably selected according to the bacterial culture and susceptibility test results,to ensure the efficacy of anti-infective therapy.

关 键 词：化脓性脑膜炎 儿童 病原菌分布 耐药性 

分 类 号：R915[医药卫生—微生物与生化药学] R969.3[医药卫生—药学]