细菌性脑膜炎症候群患儿菌群情况及其耐药分析

Investigation of bacterial flora in children with bacterial meningitis syndrome and analysis of susceptibility and drug resistance

目的调查研究细菌性脑膜炎症候群患儿菌群情况以及耐药情况。方法选择199例细菌性脑膜炎症候群患儿为研究对象,采集所有患儿的脑脊液标本完成细菌培养以及药敏试验。分析病原菌分布情况及主要病原菌耐药特点。结果199例患儿脑脊液共检出病原菌61株,按照占比从高到低的顺序分别为肺炎链球菌、无乳链球菌、大肠埃希菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌、屎肠球菌、白色念球菌、脑膜炎奈瑟菌及其他,占比分别为31.15%、21.31%、19.67%、16.39%、3.28%、3.28%、1.64%、1.64%、1.64%。大肠埃希菌对亚胺培南以及美罗培南的耐药性均为0,对其他抗菌药物均有不同程度的耐药性;脑膜炎奈瑟菌对亚胺培南、美罗培南、头孢曲松以及头孢噻肟耐药性均为0,对其他抗菌药物均有不同程度的耐药性。肺炎链球菌对万古霉素的耐药性均为0,对其他抗菌药物均有不同程度的耐药性;无乳链球菌对头孢哌酮的耐药性为0,对环丙沙星的耐药率为7.69%,而对其他抗菌药物均有明显耐药性;金黄色葡萄球菌对万古霉素以及利奈唑胺的耐药性均为0,对其他抗菌药物均有不同程度耐药性;凝固酶阴性葡萄球菌对万古霉素以及利奈唑胺的耐药性均为0,对其他抗菌药物均有不同程度耐药。结论细菌性脑膜炎症候群患儿致病菌以肺炎链球菌、无乳链球菌、大肠埃希菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌以及脑膜炎奈瑟菌为主,且不同致病菌对不同抗菌药物的耐药性不同,临床工作中应根据药敏试验结果合理选用抗菌药物。

Objective To investigate the bacterial flora and drug resistance of children with bacterial meningitis syndrome.Methods A total of 199 children with bacterial meningitis syndrome were selected as the study subjects.Cerebrospinal fluid specimens of all children were collected to complete bacterial culture and drug sensitivity test.The distribution of pathogenic bacteria and drug resistance characteristics of main pathogenic bacteria were analyzed.Results A total of 61 strains of pathogenic bacteria were detected in the cerebrospinal fluid of 199 children,which were Streptococcus pneumoniae,Streptococcus,Escherichia coli,Staphylococcus aureus,Coagulase-negative staphylococci,Enterococcus faecalis,Candida albicans,Neisseria meningitidis and others in descending order of their percentage,with the percentages being 31.15%,21.31%,19.67%,16.39%,3.28%,respectively,3.28%,1.64%,1.64%,and 1.64%.Escherichia coli had no resistance to imipenem as well as meropenem,and varying degrees of resistance to other antimicrobials;Neisseria meningitidis had no resistance to imipenem,meropenem,ceftriaxone,and cefotaxime,with varying degrees of resistance to other antimicrobials;Streptococcus pneumoniae had no resistance to vancomycin,and varying degrees of resistance to other antimicrobials;Streptococcus had no resistance to cefoperazone,7.69%resistance to ciprofloxacin,and significant resistance to all other antimicrobials;Staphylococcus aureus had no resistance to vancomycin as well as linezolid,and varying degrees of resistance to all other antimicrobials;Coagulase-negative staphylococci had no resistance to vancomycin and linezolid,and varying degrees of resistance to other antimicrobials.Conclusion Streptococcus pneumoniae,Streptococcus,Escherichia coli,Staphylococcus aureus,Coagulase-negative staphylococci and Neisseria meningitidis are the main pathogenic bacteria in children with bacterial meningitis syndrome,and different pathogenic bacteria have different drug resistance to different antimicrobials.Antimicrobials should be rationally selected according to the resuts of drug sensitivity test in clinical work.