婴幼儿化脓性脑膜炎病原菌分布及药物敏感性分析

Distribution of pathogenic bacteria and analysis of drug sensitivity in infants with purulent meningitis

目的 了解本院近年婴幼儿化脓性脑膜炎病原菌分布及耐药性,为临床化脓性脑膜炎患儿的诊断及抗菌药物的合理使用提供参考。方法 回顾性分析2016年10月—2021年10月入住本院,确诊化脓性脑膜炎患儿脑脊液培养结果。结果 共分离出病原菌396株,革兰阴性菌194株(占48.99%),革兰阳性菌174株(占43.93%),真菌28株(占7.09%)。前5位分别依次为大肠埃希菌(25.50%)、凝固酶阴性葡萄球菌(14.65%)、肺炎克雷伯菌(10.10%)、屎肠球菌(6.81%)、单核细胞增生李斯特菌(6.81%)。真菌以酵母菌为主(93.34%),隐球菌仅分离出1株。结论 婴幼儿化脓性脑膜炎病原菌以大肠埃希菌居多,革兰阳性菌对于万古霉素具有较高敏感性。早期准确的病原学报告,对于临床明确诊断,及时规范、合理使用抗菌药物,遏制耐药菌的蔓延都具有重要的临床意义。

Objective This paper aims to investigate the distribution and drug resistance of pathogens in children with purulent meningitis in our hospital in recent years, so as to provide reference for clinical diagnosis of children with purulent meningitis and rational use of antibacterial drugs. Methods The culture results of cerebrospinal fluid in children with purulent meningitis admitted to our hospital from October 2016 to October 2021 were retrospectively analyzed. Results A total of 396 strains of pathogenic bacteria were isolated, including 194 strains of gram-negative bacteria(48.99%), 174 strains of gram-positive bacteria(43.93%) and 28 strains of fungi(7.09%). The top 5 were Escherichia coli(25.50%), Coagulase negative Staphylococcus(14.65%), Klebsiella pneumoniae(10.10%), Enterococcus faecium(6.81%) and Listeria monocytogenes(6.81%). The main fungi was Saccharomyces yeasts(93.34%), and only 1 strain of Cryptococcus was isolated. Conclusion The dominant pathogen of purulent meningitis in infants is Escherichia coli, and gram-positive organisms is highly susceptible to Vancomycin. Early and accurate etiological reports are of great clinical significance for clear clinical diagnosis, timely standardized and rational use of antibiotics, and containment of the spread of drug-resistant bacteria.