细菌性脑膜炎的病原体及抗生素敏感性分析

Analysis of Pathogen and Antimicrobial Susceptibility in Children with Bacterial Meningitis

目的 回顾分析我院 1 997～ 2 0 0 3年儿童细菌性脑膜炎 (菌脑 )的病原体及其抗生素敏感性。方法 分析符合菌脑临床诊断患儿脑脊液或血培养分离菌及其药敏试验结果。结果 菌脑 40 1例患儿中 97例细菌培养阳性 ,诊断阳性率 2 4 % ,最常见病原菌为金黄色葡萄球菌 (2 8% ) ,其次是肺炎链球菌 (1 9% )与大肠杆菌 (1 3 % ) ,并出现条件致病菌如微球菌。金黄色葡萄球菌分离株对青霉素不敏感 ,其中 1株对万古霉素与替考拉宁耐药 ;大肠杆菌、肠杆菌和假单胞菌均有对泰能的耐药株。结论 金黄色葡萄球菌是菌脑主要病原菌 ,临床用药须考虑当地的病原菌及其耐药问题。

Objective Pathogen and antimicrobial susceptibility in children with bacterial meningitis were reviewed.Methods The positive cultures of cerebrospinal fluid samples or blood samples and its antimicrobial susceptibility were analyzed in 401 patients with the clinical diagnosis of bacterial meningitis.Results 401 cases cerebrospinal fluid samples and blood samples submitted to microbiology laboratory, 97 cases (24%) were microscopically and culturally proven to be bacterial meningitis. The most frequent pathogen was staphylococcus aureus (28%), followed by the streptococcus pneumoniae (19%) and escherichia coli (13%). Pediococci as conditioned pathogen, were found in purulent meningitis patients. One of the isolates of Staphylococcus aureus was simultaneously resistant to both vancomycin and teicoplanin. Three isolates showed simultaneous resistance to imipenem/cilastatin.Conclusions Staphylococcus aureus as the predominant pathogens of pediatric ranks first among pediatric patients of purulent meningitis. Serious drug resistance of isolated pathogenic bacteria and its in antimicrobial susceptibility in the bacterial meningitis should be considered in clinical therapy.