化脓性脑膜炎的病原菌分布与药敏试验分析

Analysis of pathogen distribution and susceptibility testing of patients with purulent meningitis

目的：分析化脓性脑膜炎（PM ）患儿感染病原菌分布及耐药率，为临床合理应用抗菌药物提供依据。方法选取2012年1月－2014年2月141例PM患儿根据发病年龄分为4组，＜1月龄的患儿32例（新生儿组）、1～12月龄的患儿45例（婴儿组）、1～6岁的患儿30例（幼儿组）、＞6岁的患儿34例（儿童组），采集4组患儿脑脊液行细菌培养，采用A PI系统鉴定病原菌，采用K‐B法行药敏试验，比较4组病原菌分布及药敏试验结果。结果新生儿组、婴儿组、幼儿组、儿童组检出革兰阳性球菌分别占40．63％、66．67％、83．33％、85．29％，多为耐甲氧西林菌株，检出革兰阴性杆菌分别占59．38％、33．33％、16．67％、14．71％；革兰阳性球菌对万古霉素的敏感率为100．00％，革兰阴性杆菌对亚胺培南的敏感率为100．00％。结论不同年龄PM 患儿感染病原菌不同，临床应根据患儿发病年龄选择不同的抗菌药物，提高治疗的针对性。

OBJECTIVE To analyze distribution and drug resistance for pathogens in children with purulent meningi‐tis （PM ） ,so as to provide the basis for clinical rational use of antimicrobial drugs .METHODS Totally 141 PM children during Jan .2012 to Feb .2014 were selected and divided into four groups according to age ,i .e .,the new‐born group （n=32 ,age 6 years） .Cerebrospinal fluid of children in the four groups was collected for bacterial culture using the API system to identify the pathogens and using K‐B method for drug susceptibility testing .The results of antimicrobial susceptibility test for the four groups were compared . RESULTS The detection rate of gram‐positive cocci was 40 .63% ,66 .67% ,83 .33% ,and 85 .29% in the newborn group ,the infant group ,the toddler group ,and the child group ,mostly were methicillin‐resistant strains .The detection rate of gram‐negative bacilli was 59 .38% ,33 .33% ,16 .67% ,and 14 .71% in the above groups .The sensitivity of gram‐positive cocci to vancomycin was 100 .00% and the sensitivity of gram‐negative bacilli to imi‐penem was 100 .00% .CONCLUSION Pathogens are different in PM children of different ages .Therefore ,clinical antimicrobial agents should be selected according to the different age of children ,so as to improve the pertinence of treatment .