应用布拉氏酵母菌预防儿童化脓性脑膜炎治疗中真菌感染的观察

Observation on preventive effect of Saccharomyces boulardii on fungal infection in treatment of children with suppurative meningitis

目的:探讨布拉氏酵母菌预防儿童化脓性脑膜炎长期使用抗生素后继发真菌感染的疗效。方法:将住院治疗的60例长期使用抗生素儿童化脓性脑膜炎患儿分为布拉氏酵母菌组、双歧杆菌三联活菌组及对照组,每组20例。布拉氏酵母菌组患儿自使用抗生素开始口服布拉氏酵母菌散剂(亿活),双歧杆菌三联活菌组自使用抗生素开始口服双歧杆菌三联活菌肠溶胶囊(贝飞达),对照组患儿仅使用抗生素。抗生素使用2周内观察患儿出现鹅口疮和抗生素相关性腹泻的发生率,取患儿的粪便进行真菌培养。结果:应用三代头孢菌素后6天,对照组患儿即出现口腔急性假膜型念珠菌感染,2周内口腔急性假膜型念珠菌病共9例和腹泻15例,腹泻患儿粪便白色念珠菌检出率高达60%;双歧杆菌三联活菌组患儿在应用抗生素8天后出现口腔急性假膜型念珠菌病7例和腹泻11例,腹泻患儿粪便中检出白色念珠菌6例;布拉氏酵母菌组患儿在应用抗生素12天后才出现口腔急性假膜型念珠菌病和腹泻各2例,且腹泻患儿粪便中未检出白色念珠菌。结论:对长期应用抗生素的化脓性脑膜炎患儿加用布拉氏酵母菌可有效预防继发性真菌感染。

Objective： To explore the curative effect of Saccharomyces boulardii on preventing secondary fungal infection after long time application of antibiotics in children with suppurative meningitis. Methods： Sixty children diagnosed as suppurative meningitis and treated with long time antibiotics in the hospital were selected and divided into Saccharomyces boulardii group, Bifidobacterium group, and control group, twenty children in each group. The children in Saccharomyces boulardii group were treated with oral administration of Saccha- romyces boulardii power since they were treated with antibiotics, the children in Bifidobacterium group were treated with Bifidobacterium since they were treated with antibiotics, while the children in control group were only treated with antibiotics. The incidence rates of thrush and an- tibiotic - associated diarrhea were observed within two weeks after application of antibiotics ; the fecal samples of children were obtained to conduct fungal culture. Results： At six days after applying the third generation of Cephalosporin, 9 children in control group were found with oral acute pseudomembrane -type Candida infection, and 15 children were found with diarrhea within two weeks, the detection rate of Candi- da albicans in fecal samples of diarrheal children was as high as 60% ; at eight days after applying the third generation of Cephalosporin, 7 children in Bifidobacterium group were found with oral acute pseudomembrane - type Candida infection, and 11 children were found with di- arrhea, Candida albicans was detected in fecal samples of 6 diarrheal children ; at eleven days after applying the third generation of Cephalo- sporin, two children in Saccharomyces boulardii group were found with oral acute pseudomembrane - type Candida infection, and two children were found with diarrhea, Candida albicans was not detected in fecal samples of the diarrheal children. Conclusion： Applying Saccharomy- ces botdardii in children with suppurative meningitis after long time application of antibiotics can effectively prevent secondary fungal infec-tion.