儿童急性细菌性脑膜炎的病因及抗菌药物耐药模式：伊朗西北部一家转诊医院的10年研究
Etiology and antimicrobial resistance patterns of acute bacterial meningitis in children: a 10-year referral hospital-based study in northwest iran.
作者信息
Abdinia Babak, Ahangarzadeh Rezaee Mohammad, Abdoli Oskouie Shahram
机构信息
Department of Pediatrics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran.
Tabriz Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran.
出版信息
Iran Red Crescent Med J. 2014 Jul;16(7):e17616. doi: 10.5812/ircmj.17616. Epub 2014 Jul 5.
BACKGROUND
Bacterial meningitis is still considered as one of the most dangerous infectious diseases, which causes numerous complications and high mortality if not diagnosed and treated timely.
OBJECTIVES
This study was performed to determine antimicrobial resistance patterns of bacterial pathogens isolated from acute bacterial meningitis at Tabriz Children Educational-Health Care Center in Iran.
PATIENTS AND METHODS
In a retrospective study (from 2003 through 2013), all patients with bacterial meningitis were identified by cerebrospinal fluids with positive results in culture (107 cases). Patients' necessary data was recorded in a questionnaire. Furthermore, the results of simultaneous blood culture were also examined. Ultimately, antimicrobial susceptibility of isolates was determined using the disc diffusion method.
RESULTS
One hundred and seven patients with bacterial meningitis were identified by cerebrospinal fluids with positive results in culture. All of patients (100%) had fever (male/female = 1.27/1). The most prevalent pathogens isolated from CSF culture were Streptococcus pneumoniae (34.5%), Haemophilus influenzae type b (23.36%), Neisseria meningitidis (6.54%), Serratia spp. (6.54%), and Klebsiella pneumoniae (5.6%), respectively. Moreover, the patients' blood culture had positive results in 36.44% of cases with H. influenzae type b (20.65%) and S. pneumoniae (6.54%) as the main bacteria isolated from blood. Meningitis occurred mostly in children under two years (P = 0.001). According to antimicrobial susceptibility test, a relatively high resistance was reported against some conventional cephalosporins and other antibiotics.
CONCLUSIONS
S. pneumoniae and H. influenzae type b were the main pathogens of bacterial meningitis in children in the area under study. Most species had relatively high resistance to conventional antibiotics as compared to the past.
背景
细菌性脑膜炎仍被视为最危险的传染病之一，若不及时诊断和治疗，会引发众多并发症并导致高死亡率。
目的
本研究旨在确定从伊朗大不里士儿童教育保健中心急性细菌性脑膜炎分离出的细菌病原体的抗菌耐药模式。
患者与方法
在一项回顾性研究（2003年至2013年）中，通过脑脊液培养结果呈阳性确定所有细菌性脑膜炎患者（107例）。患者的必要数据记录在问卷中。此外，还检查了同时进行的血培养结果。最终，采用纸片扩散法确定分离株的抗菌药敏性。
结果
通过脑脊液培养结果呈阳性确定了107例细菌性脑膜炎患者。所有患者（100%）均有发热（男/女 = 1.27/1）。从脑脊液培养中分离出的最常见病原体分别是肺炎链球菌（34.5%）、b型流感嗜血杆菌（23.36%）、脑膜炎奈瑟菌（6.54%）、沙雷氏菌属（6.54%）和肺炎克雷伯菌（5.6%）。此外，36.44%的病例血培养结果呈阳性，其中b型流感嗜血杆菌（20.65%）和肺炎链球菌（6.54%）是从血液中分离出的主要细菌。脑膜炎大多发生在两岁以下儿童中（P = 0.001）。根据抗菌药敏试验，对一些传统头孢菌素和其他抗生素的耐药性较高。
结论
在所研究地区，肺炎链球菌和b型流感嗜血杆菌是儿童细菌性脑膜炎的主要病原体。与过去相比，大多数菌种对传统抗生素的耐药性相对较高。
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