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评估儿童脑膜炎中的细菌流行情况和耐药性:保护中枢神经系统

Assessing bacterial prevalence and resistance in paediatric meningitis: safeguarding the central nervous system.

作者信息

Bhatti Sania, Chaurasia Bipin, Yaqoob Eesha, Ameer Jannat, Shehzad Yasir, Shahzad Khuram, Mahmood Ashraf, Scalia Gianluca, Umana Giuseppe Emmanuele, Javed Saad

机构信息

Department of Neurosurgery, Holy Family Hospital, Rawalpindi Medical University, Rawalpindi.

Neurosurgery Clinic, Birgunj, Nepal.

出版信息

Ann Med Surg (Lond). 2024 Mar 12;86(5):2671-2676. doi: 10.1097/MS9.0000000000001953. eCollection 2024 May.

Abstract

INTRODUCTION

Paediatric bacterial meningitis (PBM) represents a major contributor to childhood morbidity and mortality globally, with heightened susceptibility in low- and middle-income nations where antimicrobial resistance (AMR) is highly prevalent. Pakistan exemplifies this setting, with widespread antibiotic overuse driving AMR expansion. Thus, expediting PBM diagnosis and targeted antibiotic therapy is imperative yet challenged by the dynamic local epidemiology. This study aimed to delineate the recent bacterial etiologies and AMR profiles of PBM from a major Pakistani diagnostics laboratory to inform empirical treatment.

MATERIALS AND METHODS

This prospective observational investigation evaluated PBM epidemiology in patients under 18 years old admitted to the study hospital. Standard cerebrospinal fluid analysis identified bacterial pathogens and antibiotic susceptibility patterns.

RESULTS

Among 171 PBM cases, 152 (88.9%) had bacterial isolates confirmed via culture. The cohort was 42.7% male with a mean age of 3 months. The most prevalent pathogens among infants younger than 3 months were , and , contrasting with and predominating in older children. Staphylococcal isolates exhibited considerable penicillin and erythromycin resistance but maintained vancomycin and linezolid susceptibility. Other resistance patterns varied.

CONCLUSION

These findings highlight the pressing threat of paediatric AMR in Pakistan, underscoring the need for vigilant AMR surveillance and judicious antimicrobial use. This study provides a reference to current PBM epidemiology to guide context-specific empirical therapy.

摘要

引言

小儿细菌性脑膜炎(PBM)是全球儿童发病和死亡的主要原因之一,在抗菌药物耐药性(AMR)高度流行的低收入和中等收入国家,其易感性更高。巴基斯坦就是这种情况的典型代表,抗生素的广泛滥用推动了AMR的扩大。因此,加快PBM的诊断和针对性抗生素治疗势在必行,但当地动态的流行病学情况给这一工作带来了挑战。本研究旨在从巴基斯坦一家主要诊断实验室描绘PBM近期的细菌病因和AMR谱,为经验性治疗提供依据。

材料与方法

这项前瞻性观察性研究评估了入住研究医院的18岁以下患者的PBM流行病学情况。标准脑脊液分析确定了细菌病原体和抗生素敏感性模式。

结果

在171例PBM病例中,152例(88.9%)通过培养确认有细菌分离株。该队列中男性占42.7%,平均年龄为3个月。3个月以下婴儿中最常见的病原体是 和 ,而在大龄儿童中 和 占主导地位。葡萄球菌分离株对青霉素和红霉素表现出相当程度的耐药性,但对万古霉素和利奈唑胺仍敏感。其他耐药模式各不相同。

结论

这些发现凸显了巴基斯坦小儿AMR的紧迫威胁,强调了对AMR进行警惕监测和明智使用抗菌药物的必要性。本研究为当前PBM流行病学提供了参考,以指导针对具体情况的经验性治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf08/11060287/1395e4d3f936/ms9-86-2671-g001.jpg

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