细菌性脑膜炎患儿脑脊液病原菌分布及药敏实验分析  

Distribution of pathogenic bacteria in cerebrospinal fluid of children with bacterial meningitis and analysis of drug sensitivity test

作　　者：张羽[1] 武胜涛[1] 朱金玉[1] Zhang Yu;Wu Shengtao;Zhu Jinyu(Nanyang Central Hospital,Nanyang 473000,Henan,China)

机构地区：[1]南阳市中心医院,河南南阳473000

出　　处：《临床心身疾病杂志》2023年第1期109-112,共4页Journal of Clinical Psychosomatic Diseases

基　　金：南阳市科技发展计划项目(编号201801530)。

摘　　要：目的探讨细菌性脑膜炎患儿脑脊液病原菌分布和药敏实验结果,为临床治疗提供依据。方法采集86例细菌性脑膜炎患儿的脑脊液标本,行病原菌培养和药敏实验,进行多重耐药菌筛查及耐药情况分析。结果86份脑脊液标本中,共分离出病原菌94株,其中革兰氏阴性菌38株,占40.43%,以大肠埃希菌、肺炎克雷伯菌为主;革兰氏阳性菌56株,占59.57%,以肺炎链球菌、金黄色葡萄球菌为主。大肠埃希菌对氨苄西林(92.86%)、磺胺甲噁唑(78.57%)耐药率较高;肺炎克雷伯菌对氨苄西林(100%)、头孢噻肟(91.67%)耐药率较高,对环丙沙星(8.33%)耐药性低;肺炎链球菌对红霉素(100%)耐药率较高,对氨苄西林、万古霉素、环丙沙星及庆大霉素无耐药性;金黄色葡萄球菌对氨苄西林(100%)耐药率较高,对庆大霉素、万古霉素、头孢噻肟及氯霉素无耐药性。结论细菌性脑膜炎患儿感染的病原菌情况较复杂,不同病原菌对抗菌药物具有不同程度的敏感性,临床可根据药敏实验结果对症给药,规范使用抗生素,减少耐药菌株的产生。Objective To explore the distribution of pathogenic bacteria in cerebrospinal fluid of children with bacterial meningitis and the results of drug sensitivity test,so as to provide evidence for clinical treatment.Methods The cerebrospinal fluid samples of 86 children with bacterial meningitis were collected,and the pathogen culture and drug sensitivity test were performed.The multi-drug resistant bacteria were screened and drug resistance was analyzed.Results A total of 94 strains of pathogenic bacteria were isolated from 86 cerebrospinal fluid samples,including 38 strains of Gram-negative bacteria,accounting for 40.43%,mainly Escherichia coli and Klebsiella pneumoniae;56 strains of Gram-positive bacteria,accounting for 59.57%,mainly Streptococcus pneumoniae and Staphylococcus aureus.Escherichia coli has a high resistance rate to ampicillin(92.86%)and sulfamethoxazole(78.57%).Klebsiella pneumoniae has a high resistance rate to ampicillin(100%)and cefotaxime(91.67%),and a low resistance rate to ciprofloxacin(8.33%).Escherichia coli has a high resistance rate to ampicillin(92.86%)and sulfamethoxazole(78.57%).Klebsiella pneumoniae has a high resistance rate to ampicillin(100%)and cefotaxime(91.67%),and a low resistance rate to ciprofloxacin(8.33%).Streptococcus pneumoniae has a high resistance rate to erythromycin(100%),and no resistance to ampicillin,vancomycin,ciprofloxacin and gentamicin.Staphylococcus aureus has a high resistance rate to ampicillin(100%),and no resistance to gentamicin,vancomycin,cefotaxime and chloramphenicol.Conclusions The pathogenic bacteria in children infected with bacterial meningitis are complicated,and different pathogenic bacteria have different degrees of sensitivity to antibacterial drugs.According to the results of drug sensitivity test,the drug can be administered according to the symptoms,and the use of antibiotics can be standardized to reduce the generation of drug-resistant strains.

关 键 词：细菌性脑膜炎 儿童 病原菌 药敏实验 耐药性 抗生素 

分 类 号：R725[医药卫生—儿科] R117[医药卫生—临床医学]