摘要
目的探讨近10 a细菌性脑膜炎患儿的临床变化。方法选取2004年5月至2014年5月河南省人民医院收治的760例细菌性脑膜炎患儿作为研究对象,按照患儿入院时间分为A组（2004-2008年,333例）和B组（2009-2014年,427例）。对2组患儿的性别、地域、发病季节、发病年龄进行比较,并对患儿的病原菌及耐药性进行分析。结果 760例患儿中男女比例为1.4∶1,农村与城市患儿比例为1.8∶1,春、夏、秋、冬季患病人数分别为238例、195例、144例和183例,春季为患儿最易患病季节;年龄≤3岁的患儿488例（62.6%）,年龄〉3岁的患儿272例（37.4%）,细菌性脑膜炎多发于婴幼儿。B组女性患儿比例高于A组（P〈0.05）,B组1-3个月患儿比例高于A组（P〈0.05）,B组城市患儿比例高于A组（P〈0.05）,B组秋季患儿比例高于A组（P〈0.05）;760例患儿共分离获得病原菌760株,其中凝固酶阴性葡萄球菌262例（34.43%）,肺炎链球菌182例（23.94%）。凝固酶阴性葡萄球菌对头孢曲松、氨苄西林、青霉素、红霉素和克拉霉素的耐药率〉70%,对头孢拉定和头孢西丁的耐药率〉50%;金黄色葡萄球菌对氨苄西林、青霉素、红霉素和克拉霉素的耐药率〉70%,肺炎链球菌对青霉素和克拉霉素的耐药率〉55%,大肠埃希菌和肺炎克雷伯菌对复方磺胺甲唑的耐药率〉50%,铜绿假单胞菌对头孢西丁的耐药率〉50%。结论细菌性脑膜炎发病率呈上升趋势,多发于婴幼儿,女性、城市、秋季和冬季发病率有增加趋势;凝固酶阴性葡萄球菌为儿童细菌性脑膜炎的主要病原菌,且耐药率较高。
Objective To investigate the clinical changes in bacterial meningitis in children during past ten years.Methods A total of 760 children with bacterial meningitis in Henan Provincial People＇s Hospital from May 2004 to May 2014 were selected as the subjects. The children were divided into group A（ from 2004 to 2008,333 cases） and group B（ from 2009 to 2014,427 cases） according to the admission time. The sex,region,nosogenic season and onset age of the children were compared between the two groups. The pathogenic bacteria and drug resistance were analyzed. Results In the 760 children,the male to female ratio was 1. 4∶1;the ratio of rural children to urban children was 1. 8∶1. The number of children in spring,summer,autumn and winter was 238,195,144 and 183 cases,respectively. The spring was the most susceptible season for children. Among the 760 children,the age less than or equal to 3 years old in 488 cases（62. 6%）,the age above 3 years old in272 cases（37. 4%）. The infant was the susceptible population of bacterial meningitis. Compared with group A,the female ratio was higher（ P〈0. 05）,the ratio of children in 1- 3 months was higher（ P〈0. 05）,the ratio of urban children was higher（ P〈0. 05）,and the ratio of children in autumn was higher in group B（ P〈0. 05）. Among the 760 pathogenic bacteria which were isolated from the 760 children,262 cases（34. 43%） were coagulase negative staphylococcus,182 cases（23. 94%） were Streptococcus pneumoniae. The resistance rate of coagulase negative staphylococcus to ceftriaxone,ampicillin,penicillin,erythromycin and clarithromycin was more than 70%,and the resistance rate of coagulase negative staphylococcus to cefradine and cefoxitin was more than 50%. The resistance rate of Staphylococcus aureus to ampicillin,penicillin,erythromycin and clarithromycin was more than 70%. The resistance rate of Streptococcus pneumoniae to penicillin and clarithromycin was more than 50%. The resistance rate of Escherichia coli and klebsiella pneumoniae to compound sulfamethoxazole was more than 50%. The resistance rate of Pseudomonas aeruginosa to cefoxitin was more than 50%. Conclusions The incidence rate of bacterial meningitis has increasing trend,and the infant was the susceptible population of bacterial meningitis. The incidence rate of bacterial meningitis in female,city,autumn and winter has increasing trend. Coagulase negative staphylococcus is the main pathogenic bacteria of bacterial meningitis in children,and it has high resistance rate.
出处
《新乡医学院学报》
CAS
2015年第6期533-536,共4页
Journal of Xinxiang Medical University
关键词
细菌性脑膜炎
病原菌
耐药性
bacterial meningitis
pathogenic bacteria
drug resistance
