摘要
目的分析儿科住院患儿肺炎链球菌(SP)脑膜炎的临床特征,同时对培养出的SP菌株进行抗菌药物耐药性分析,以帮助临床早期诊断,合理选用抗菌药物。方法回顾性分析2008年9月至2014年3月收治的14例SP脑膜炎患儿的临床资料并进行耐药性分析。结果 14例SP脑膜炎患儿中,高热13例(93%),抽搐9例(64%),合并败血症7例(50%)。白细胞计数增高11例(79%),CRP增高10例(71%)。所有患儿脑脊液有核细胞计数增高,分类均以中性粒细胞为主,9例(64%)患儿脑脊液蛋白定量结果 >1 000 mg/d L。经治疗后10例(71%)患儿痊愈,2例(14%)患儿有后遗症,2例(14%)患儿死亡。SP对青霉素、红霉素、克林霉素、四环素和磺胺耐药率高,均高于60%,对阿莫西林耐药率较低(7%),未发现对万古霉素、氯霉素、左旋氧氟沙星耐药菌株。结论实验室辅助检查指标对于区分SP脑膜炎和其他病原菌引起的脑膜炎无特异性。SP对儿科临床常用抗菌药物耐药情况严重,因此对SP的耐药情况应进行检测,以指导临床用药。
ObjectiveTo study the clinical characteristics of children with meningitis caused byStreptococcus pneumoniae （SP） and the drug sensitivity of SP strains.MethodsA retrospective analysis was performed on the clinical data of 14 children with SP-infected meningitis between September 2008 and March 2014.ResultsOf the 14 cases, 8 cases （57%） aged under 2 years. 13 cases （93%） had fever, 9 cases （64%） had convulsions, and 7 cases （50%） were complicated by septicemia. Eleven cases （79%） had elevated white blood cell （WBC） counts and 10 cases （71%） had elevated serum C-reactive protein （CRP） levels. All 14 children had an elevated nucleated cell count and neutrophils were identiifed as the predominant cell type. CSF protein 〉1 000 mg/dL was noted in 9 cases （64%）. Ten cases （71%） were cured, 2 cases （14.2%） with sequelae and 2 cases （14.2%） died. The drug sensitivity analysis showed that SP had resistance rates of more than 60% to penicillin, erythromycin, clindamycin, tetracycline and sulfa, but it was sensitive to amoxicillin （93%）, vancomycin （100%）, chloramphenicol （100%） and levolfoxacin （100%）.ConclusionsThe clinical characteristics of children with meningitis caused by SP are not different from those with meningitis caused by other bacteria. SP strains are resistant to common antibiotics used in clinical practice, so it is important to monitor the drug resistance of the strains.
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2015年第7期706-709,共4页
Chinese Journal of Contemporary Pediatrics
关键词
肺炎链球菌
脑膜炎
临床特点
耐药
儿童
Streptococcus pneumoniae
Meningitis
Clinical characteristics
Drug resistance
Child
