摘要
目的分析某院2000年1月-2005年12月收治的156例化脓性脑膜炎新生儿病原菌分布及其耐药性，为临床合理用药治疗提供依据。方法无菌抽取脑脊液进行普通培养和高渗培养，采用法国生物梅里埃API系统鉴定细菌；药敏试验采用K—B法，超广谱β-内酰胺酶（ESBLs）检测采用双纸片扩散法。结果共获需氧菌156株，其中革兰阴性（G^-）杆菌42株（26．92％），以大肠埃希菌（11株，26．19％）、不动杆菌属（5株，11．91％）、肺炎克雷伯菌（4株，9．52％）、变形杆菌（4株，9．52％）为主，检出产ESBLs菌12株（28．57％）；革兰阳性（G^＋）球菌103株（66．03％），以表皮葡萄球菌（56株，54．37％）、溶血葡萄球菌（7株，6．80％）为主；其他菌种11株（7．05％）。2003-2005年G^-杆菌占全部检出菌的比率为35．14%，高于2000-2002年的检出率19．51％（X^2=4．83，P〈0．05）。G^-杆菌对亚胺培南、头孢曲松、头孢哌酮等较敏感；G^＋球菌对头孢噻肟、头孢哌酮、头孢曲松等较敏感。结论新生儿化脓性脑膜炎病原菌以表皮葡萄球菌、大肠埃希菌、溶血葡萄球菌为主，G^-杆菌检出率有逐年上升趋势，临床应根据药敏结果合理选择抗菌药物。
Objective To analyse the pathogenic distribution and drug resistance in 156 hospitalized neonates with purulent meningitis from January, 2000 to December, 2005, so as to provide the basis for the rational application of antimicrobial agents in clinic. Methods Cerebral spinal fluid specimen was inoculated on blood agar and high osmolar agar culture medium, bacteria were identified by an automated API system; antimicrobial susceptibility tests were performed by Kirby-Bauer method, extended spectrum β-lactamases （ESBLs） were detected by double-disk diffusion method. Results One hundred and fifty-six strains of aerobic bacteria were isolated, 42（26. 92%） of which were gram-negative bacilli, the main gram-negative bacilli were Escherichia coli （ 11 strains, 26. 19 % ）, Acinetobacter spp. （5 strains,ll. 91%）, Klebsiella pneumoniae （4 strains,9. 52%）, Proteus（4 strains,9. 52%）, 12（28. 57%） strains produced ESBLs; 103 （66. 03 %） of the 156 strains were gram-positive cocci, Staphylococcus epidermidis （56 strains, 54. 37%）, Staphylococcus haernolyticus （7 strains, 6. 80%） were the main gram-positive cocci; 11 （7. 05 %） were the other bacteria. The isolation rate of gram-negative bacilli during 2003-2005 was 35.14 %, which was higher than 19. 51% during 2000 - 2002（x^ 2= 4.83, P〈0.05）. Gram-negative bacilli were sensitive to imipem, ceftriaxone and cefoperazone; and the gram-positive cocci were sensitive to cefotaxime, cefoperazone and ceftriaxone. Conclusion The main pathogens of neonatal purulent meningitis are Staphylococcus epidermidis, Escherichia coli and Staphylococcus haemolyticus, the isolation rate of gram-negative bacilli are in rising trend year by year, antimicrobial agents should be selected rationally based on the results of the antimicrobial susceptibility test result.
出处
《中国感染控制杂志》
CAS
2007年第2期117-119,126,共4页
Chinese Journal of Infection Control
关键词
新生儿
化脓性脑膜炎
病原菌
抗药性
微生物
抗菌药物
neonates
purulent meningitis
pathogen
drug resistance, microbial
antimicrobial agents
