[90日龄以下婴儿细菌性脑膜炎病因学特征的多中心研究]
[Multicenter study on etiological characteristics of bacterial meningitis in infants aged < 90 days].
作者信息
Liu Ying, Feng Xue, Gao Jin, Xiong Ying, Liu Chang, Hou Xin-Lin
机构信息
Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2025 Jun 15;27(6):648-653. doi: 10.7499/j.issn.1008-8830.2412038.
OBJECTIVES
To investigate the etiological characteristics of bacterial meningitis (BM) in infants aged <90 days.
METHODS
A retrospective analysis was conducted on the etiology and outcomes of BM in infants aged <90 days admitted to five collaborating hospitals between January 2007 and December 2021. The overall etiological profile was described, and pathogen distributions were compared across different age groups, regions, and years. The prognosis of BM caused by common pathogens was also evaluated.
RESULTS
A total of 197 infants with bacteriologically confirmed BM were included. The most common pathogens were (E. coli) (72 cases, 36.5%), group B (GBS) (49 cases, 24.9%), and (LM) (11 cases, 5.6%). The detection rate of E. coli was significantly higher in the neonatal group than in the infant group (40.2% vs 18.2%, <0.05). E. coli was the predominant pathogen in Beijing (31.7%) and Kunming (54.1%), while GBS and E. coli were equally prevalent in Shenzhen (33.3%). From 2018 to 2021, the detection rates of E. coli were 46.4%, 47.2%, 45.2%, and 36.8%, respectively, whereas those of GBS were 25.0%, 27.8%, 22.6%, and 31.6%. No significant difference was observed in the overall complication rates among BM cases caused by E. coli, GBS, and LM (>0.05). However, ventriculitis and hydrocephalus were more frequent in LM meningitis than in GBS meningitis (<0.017).
CONCLUSIONS
E. coli is the most common pathogen in BM among young infants, particularly neonates. GBS is predominant in Shenzhen, with an increasing trend. LM meningitis accounts for a notable proportion of cases and is associated with poorer outcomes.
目的
探讨90日龄以下婴儿细菌性脑膜炎（BM）的病因特征。
方法
对2007年1月至2021年12月期间在五家合作医院收治的90日龄以下婴儿BM的病因及转归进行回顾性分析。描述总体病因概况，并比较不同年龄组、地区和年份的病原体分布。还评估了常见病原体所致BM的预后。
结果
共纳入197例经细菌学确诊的BM婴儿。最常见的病原体是大肠埃希菌（E. coli）（72例，36.5%）、B组链球菌（GBS）（49例，24.9%）和单核细胞增生李斯特菌（LM）（11例，5.6%）。大肠埃希菌在新生儿组的检出率显著高于婴儿组（40.2%对18.2%，P<0.05）。大肠埃希菌是北京（31.7%）和昆明（54.1%）的主要病原体，而GBS和大肠埃希菌在深圳的流行程度相当（33.3%）。2018年至2021年，大肠埃希菌的检出率分别为46.4%、47.2%、45.2%和36.8%，而GBS的检出率分别为25.0%、27.8%、22.6%和31.6%。大肠埃希菌、GBS和LM所致BM病例的总体并发症发生率无显著差异（P>0.05）。然而，LM脑膜炎的脑室炎和脑积水发生率高于GBS脑膜炎（P<0.017）。
结论
大肠埃希菌是小婴儿尤其是新生儿BM最常见的病原体。GBS在深圳占主导地位，且呈上升趋势。LM脑膜炎占病例的相当比例，且预后较差。
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