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2014 年 1 月至 2016 年 12 月中国 28 天以上儿童细菌性脑膜炎的临床特征和病因:一项多中心回顾性研究。

Clinical characteristics and etiology of bacterial meningitis in Chinese children >28 days of age, January 2014-December 2016: A multicenter retrospective study.

机构信息

Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China, Beijing, China; Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China.

Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China, Beijing, China.

出版信息

Int J Infect Dis. 2018 Sep;74:47-53. doi: 10.1016/j.ijid.2018.06.023. Epub 2018 Jul 6.

Abstract

OBJECTIVE

To explore the clinical characteristics and etiology of bacterial meningitis (BM) in Chinese children.

METHOD

BM cases in children 28days to 18 years old were collected from January 2014-December 2016 and screened according to World Health Organization standards. Clinical features, pathogens, and resistance patterns were analyzed.

RESULTS

Overall, 837 cases were classified into five age groups: 28 days-2 months (17.0%), 3-11 months (27.8%), 12-35 months (24.0%), 3-6 years (13.9%), and >6years (17.3%). Major pathogens were Streptococcus pneumoniae (S. pneumoniae, n=136, 46.9%), group B Streptococcus (GBS, n=29, 10.0%), and Escherichia coli (E. coli, n=23, 7.9%). In infants <3 months old, GBS (46.5%) and E. coli (23.3%) were most common; in children >3 months old, S. pneumoniae (54.7%), which had a penicillin non-susceptibility rate of 55.4% (36/65), was most frequent. The resistance rates of S. pneumoniae and E. coli to cefotaxime and ceftriaxone were 14.0%/40.0% and 11.3%/68.4%, respectively. All GBS isolates were sensitive to penicillin.

CONCLUSIONS

The occurrence of BM peaked in the first year of life, while S. pneumoniae was the predominant pathogen in children >3months of old. The antibiotic resistance of S. pneumoniae was a concern.

摘要

目的

探讨中国儿童细菌性脑膜炎(BM)的临床特点和病因。

方法

收集 2014 年 1 月至 2016 年 12 月期间 28 天至 18 岁的 BM 患儿病例,根据世界卫生组织标准进行筛选。分析临床特征、病原体及耐药模式。

结果

共有 837 例患儿分为 5 个年龄组:28 天至 2 个月(17.0%)、3-11 个月(27.8%)、12-35 个月(24.0%)、3-6 岁(13.9%)和>6 岁(17.3%)。主要病原体为肺炎链球菌(136 例,占 46.9%)、B 型链球菌(29 例,占 10.0%)和大肠埃希菌(23 例,占 7.9%)。<3 个月婴儿中最常见的病原体为 B 型链球菌(46.5%)和大肠埃希菌(23.3%);>3 个月儿童中最常见的病原体为肺炎链球菌(54.7%),其对青霉素的不敏感性率为 55.4%(36/65)。肺炎链球菌和大肠埃希菌对头孢噻肟和头孢曲松的耐药率分别为 14.0%/40.0%和 11.3%/68.4%。所有 B 型链球菌分离株均对青霉素敏感。

结论

BM 发病高峰在生命的第一年,>3 个月儿童中主要病原体为肺炎链球菌。肺炎链球菌的抗生素耐药性令人关注。

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