Pathogenic bacteria distribution and drug resistance in one hundred children of bacterial meningitis
10.3969/j.issn.1000-3606.2016.02.006
- VernacularTitle:儿童细菌性脑膜炎100例病原分布及耐药分析
- Author:
Luona LIN
;
Li LIN
;
Shunhang WEN
;
Xiuzhen CHEN
;
Yanping SHANG
;
Changchong LI
- Publication Type:Journal Article
- Keywords:
bacterial meningitis;
pathogens;
antibiotic resistance;
child
- From:
Journal of Clinical Pediatrics
2016;(2):107-112
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the pathogenic bacteria distribution, antibiotics resistance, and clinical features of childhood bacterial meningitis (BM). Methods Clinical data from BM children with positive cerebrospinal lfuid culture were retrospectively analyzed from March 2004 to March 2015. According to age, the BM children were divided into neonates group (0-28 days), infants group (—1 year), and children group (≥1 year). According to the onset time, the BM children were divided into the early group (March 2004 to March 2010) and the late group (April 2010 to March 2015). According to the clinical situation, the BM children were divided into the trauma and surgery secondary infection group and the control group. Results A total of 100 BM children were recruited. One hundred and two strains of pathogens were detected, 62 (60.8%) strains of Gram positive bacteria and 40 (39.2%) strains of Gram negative bacteria. The main pathogens were Streptococcus pneumoniae (33 strains), Escherichia coli (22 strains), and Streptococcus agalactiae (10 strains). The proportion of Streptococcus agalactiae was higher in the late group (18.8%(9 cases)) than that in the early group (1.9%(1 case)) (χ2=6.406, P=0.011). The proportion of coagulase-negative staphylococci was higher in the trauma and surgery secondary infection group than that in the control group (χ2=6.631, P=0.010). Drug sensitivity analysis found that 60.0%of Escherichia coli produced extended-spectrumβ-lactamases (ESBLs) in the control group, while the only one strain of Escherichia coli in the trauma and surgery secondary infection group was ESBLs negative. Streptococcus pneumoniae were sensitive to vancomycin and linezolid. Streptococcus agalactiae were all found in the control group, which were all sensitive to penicillin and linezolid. The sensitive rate to vancomycin was only 70%. The incidence of complications in neonates group, infants group, and children group was 55.0%(22/40), 78.6%(33/42), and 33.3%(6/18), respectively. The difference was statistically signiifcant (χ2=11.848, P<0.05). The most common complications in these three age groups were ventricular dilatation (40.9%), subdural effusion (45.5%), and hydrocephalus (40.0%), respectively. Thirty-ifve children were cured, 41 children were improved and discharged, 22 children were not cured and left the hospital, and 2 children died. Conclusions Streptococcus pneumoniae, Escherichia coli, and Streptococcus agalactiae were the predominant pathogens in childhood BM. The Streptococcus agalactiae infection is increased in the late group. The complications is varied in different age groups..
