新生儿脑膜炎病原菌的分布特点及其耐药分析

Analysis of pathogen distribution and drug resistance of neonatal meningitis

目的分析新生儿脑膜炎(neonatal meningitis)脑脊液中病原菌的分布情况及主要病原菌耐药状况。方法选取2015年1月~2020年8月在我院新生儿科住院的脑脊液培养阳性的35例脑膜炎患儿的临床资料进行回顾性分析。结果35例脑膜炎患儿中脑脊液培养出9种致病菌,共35株,均为单一菌株感染;病原菌中主要以革兰阴性菌为主,占57.14%(20/35),革兰阳性菌占40%(14/35);真菌1例,占2.86%;革兰阴性菌主要以大肠埃希菌和肺炎克雷伯菌为主,两种病原菌对头孢唑林、头孢曲松等头孢菌素的耐药率较高,对阿米卡星和碳青霉烯类药物绝对敏感;其中革兰阳性菌以无乳链球菌和屎肠球菌为主,两种致病菌对红霉素绝对耐药,对替考拉宁、利奈唑胺及万古霉素绝对敏感。结论我院新生儿脑膜炎病原菌检出主要以革兰阴性菌为主,耐药性较高;治疗上应在经验用药的基础上根据药敏试验结果合理选择抗生素。

Objective To analyze the pathogen distribution and drug resistance of neonatal meningitis.Methods The clinical data of 35 cases of neonatal meningitis whose cerebrospinal fluid bacterial culture was positive from January 2015 to August 2020 were analyzed retrospectively.Results In 35 cases of neonatal meningitis,35 strains of 9 pathogenic bacteria were isolated from cerebrospinal fluid,all were infected by a single strain;Gram-negative bacteria were the main pathogenic bacteria,accounting for 57.14%(20/35),gram-positive bacteria accounted for 40%(14/35),and 1 case Fungus,accounting for 2.86%;Gram-negative bacteria were mainly Escherichia coli and Klebsiella pneumoniae,and the two pathogens had high resistance rates to ceftizolin,ceftriaxone and other cephalosporins,and all of them were sensitive to amikacin and carbapenems;Gram-positive bacteria were mainly composed of Streptococcus agalactiae and Enterococcus faecium,which were absolutely resistant to erythromycin,all of them were sensitive to teicoplanin,linezolid and vancomycin.Conclusion The pathogenic bacteria in cerebrospinal fluid of neonatal meningitis in our hospital was mainly gram-negative bacteria,and with high drug resistance;The treatment of antibiotics should be selected rationally according to the results of pathogen drug sensitivity test on the basis of empirical medication.