关键词: 细菌性脑膜炎, 病原菌, 耐药性, 用药安全

Abstract: Objective To analyze the pathogenic bacteria and drug resistance test results of children with bacterial meningitis, so as to provide the basis for the diagnosis and medication of children with bacterial meningitis in this area. Methods Descriptive epidemiological analysis method was used to analyze the pathogenic bacteria and drug resistance test results of bacterial meningitis cases diagnosed in the medical record management system of a hospital in Ganzi Tibetan Autonomous Prefecture. Results This study analyzed 355 children with bacterial meningitis diagnosed between 2010 to 2019 in a hospital in Ganzi Tibetan Autonomous Prefecture. Among them, 199 were boys and 156 were girls, accounting for 56.1% and 43.9%, respectively. The main symptoms of the cases were fever duration ≥ 3 days （52.1%）, status epilepticus （54.1%）, and convulsions （76.1%）. 355 strains （18 kinds） of pathogenic bacteria were detected, all of them were single infections.246 strains of gram-positive bacteria were detected, accounting for 69.0%, and 102 strains of gram-negative bacteria were detected, accounting for 28.7%, also 7 fungal strains were detected, accounting for 2.0%. Gram-positive bacteria were mostly Streptococcus pneumoniae （35.2%）, Streptococcus agalactiae （13.8%） and Staphylococcus aureus （13.5%）. Escherichia coli （11.5%）, Neisseria intracellularis （6.2%） and Haemophilus influenzae type B （5.6%） were the majority of Gram-negative bacteria. The resistance rate of Streptococcus pneumoniae to penicillin, ampicillin, oxacillin, vancomycin and levofloxacin were all higher than 80%, and the sensitivity rate to cefotaxime and moxifloxacin were higher than 95%. Streptococcus agalactiae did not develop severe drug resistance, but resistance rate to erythromycin was high （50.4%）. Staphylococcus aureushadvarying degrees of resistance to various antibiotics, and was relatively more sensitive to cefotaxime, cefoxitin, chloramphenicol, levofloxacin and vancomycin （70.4%-98.0%）. The resistance rate of Escherichia coli to cefuroxime and cefazolin were higher than 60%, and the sensitivity rate to chloramphenicol and imipenem were higher than 94%. Neisseria meningitidishadhigh sensitivity rate to most antibacterial drugs, and the resistance rate to ampicillin was 27.3%. Conclusion Streptococcus pneumoniae and Escherichia coli are the main pathogenic bacteria in children with bacterial meningitis in this area. These pathogenic bacteria were highly resistant to β-lactamase antibiotics, but still with high sensitivity rate to third and fourth generation cephalosporins.

Key words: Bacterial meningitis, Pathogenic bacteria, Drug resistance, Medication safety