细菌性脑膜炎病原菌分布和耐药性变迁

Distribution and Antibiotic Resistance of Pathogenic Bacteria Isolated from Patients with Bacterial Meningitis

目的了解细菌性脑膜炎致病菌的分布特点以及耐药谱的变化。方法对1996-2004年川北医学院附属医院收治的细菌性脑膜炎病例进行脑脊液和血培养,并对致病菌进行药敏试验。结果从316例患者的276份脑脊液和269份血标本中共分离出62株致病菌。葡萄球菌最多占30.6%(19/62),其次为大肠埃希菌占14.5%(9/62)、脑膜炎奈瑟菌占11.3%(7/62)和B组链球菌占9.7%(6/62)。葡萄球菌对青霉素的耐药率高于83.3%,对苯唑西林、头孢唑啉的耐药也逐渐升高。肠杆菌科细菌对氨苄西林的耐药率高达87.5%以上,且对第三代头孢菌素、左氧氟沙星的耐药呈逐年增高趋势。结论葡萄球菌、肠杆菌科细菌、脑膜炎奈瑟菌是主要致病菌。细菌耐药性普遍增加。

Objective To investigate the distribution characteristics and antibiotic resistance trend of pathogenic bacteria isolated from patients with bacterial meningitis. Method From 1996 to 2004, cerebrospinal fluid （CSF） and blood specimens for bacterial culture were collected from in-patients of our hospital. The strains were identified using automated microbial analysis system BD 9050. Antibiotic susceptibility was tested by Kirby-Bauer method. Result A total of 62 strains of pathogenic bacteria including 29 from 276 CSF specimens and 33 from 269 blood cultures collected from 316 cases were identified i. e. 30. 6% （19/62） of staphylococcus species,14.55（9/62） of Escherichia coli,11. 3% （7/62） of Neisseria meningitidis and 9. 7% （6/62） of group B streptococcus. The resistance rate of staphylococcus against penicillin was higher over 83.3% , and that against oxacillin and cefazolin was gradually increased. The resistance rate of Enterobacteriaceae against ampicillin reached over 87. 5% , and that against third generation cephalosporin and levofloxacin were increased year after year. Conclusion The staphylococcus species, Neisseria meningitidis and Enterobacteriaceae were the major bacteria and their antibiotic resistance rates were increased in general.