李雪琴;王勤;王江涛;王晓玲;赵爱玲;谷惠茹;

• 1:郑州大学附属儿童医院河南省儿童医院郑州儿童医院

摘要(Abstract)：

目的了解0～3月龄婴儿化脓性脑膜炎病原菌的分布及耐药情况,以指导临床合理用药。方法选择2015-01-01—2019-12-31在郑州大学附属儿童医院新生儿诊疗中心住院的0～3月龄婴儿的5 310份脑脊液标本为研究对象,对脑脊液培养阳性的化脓性脑膜炎婴儿病原菌分布及耐药情况进行分析。结果 5 310份CSF标本共检出细菌175株,其中革兰阳性(G⁺)菌的构成比为68%,革兰阴性(G+)菌的构成比为68%,革兰阴性(G^-)菌的构成比为32%。早期新生儿、晚期新生儿及29d～3月龄小婴儿3个年龄组CSF培养检出G-)菌的构成比为32%。早期新生儿、晚期新生儿及29d～3月龄小婴儿3个年龄组CSF培养检出G⁺菌、G+菌、G^-菌构成比差异无统计学意义(P>0.05)。CSF培养检出率排名前7位的病原菌依次为大肠埃希菌、表皮葡萄球菌、屎肠球菌、溶血葡萄球菌、人葡萄球菌、肺炎克雷伯菌、B群无乳链球菌。CSF培养病原菌中耐药菌株较多,耐药率为44%。构成比位居前5位的多重耐药菌依次为耐甲氧西林凝固酶阴性葡萄球菌(32.5%)、产超广谱-内酰胺酶菌株(22.1%)、耐甲氧西林表皮葡萄球菌(19.5%)、碳青霉烯类耐药肠杆菌(14.3%)、氨基糖苷类高水平耐药菌株(7.8%)。CSF培养病原菌中G-菌构成比差异无统计学意义(P>0.05)。CSF培养检出率排名前7位的病原菌依次为大肠埃希菌、表皮葡萄球菌、屎肠球菌、溶血葡萄球菌、人葡萄球菌、肺炎克雷伯菌、B群无乳链球菌。CSF培养病原菌中耐药菌株较多,耐药率为44%。构成比位居前5位的多重耐药菌依次为耐甲氧西林凝固酶阴性葡萄球菌(32.5%)、产超广谱-内酰胺酶菌株(22.1%)、耐甲氧西林表皮葡萄球菌(19.5%)、碳青霉烯类耐药肠杆菌(14.3%)、氨基糖苷类高水平耐药菌株(7.8%)。CSF培养病原菌中G^-菌的耐药率(58.9%)高于G-菌的耐药率(58.9%)高于G⁺菌的耐药率(37%),差异有统计学意义(P<0.05)。结论我院0～3月龄化脓性脑膜炎患儿CSF培养病原菌以G+菌为主,对抗菌药物耐药率较高。临床医师应根据菌株特点和药物敏感性试验结果,合理选用抗菌药物。

关键词(KeyWords)： 化脓性脑膜炎;婴儿;脑脊液培养;病原菌;分布;多重耐药菌

Abstract:

Keywords:

基金项目(Foundation): 郑州儿童医院联合共建项目(编号：2018020634)

作者(Authors): 李雪琴;王勤;王江涛;王晓玲;赵爱玲;谷惠茹;

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