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儿童急性细菌性脑膜炎相关微生物及流感嗜血杆菌的作用

Microorganisms involved in acute bacterial meningitis in children and the role of Haemophilus influenzae.

作者信息

Kanra G, Akan O, Ecevit Z, Ceyhan M, Seçmeer G

机构信息

Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara.

出版信息

Turk J Pediatr. 1996 Oct-Dec;38(4):407-12.

PMID:8993169
Abstract

Acute bacterial meningitis (ABM) is an important cause of mortality and neurological damage in children. Documentation of the etiological agents is very important both for the treatment of patients and for prophylactic approaches. H.influenzae, N.meningitidis and S.pneumoniae are the three major pathogens involved in ABM. In Turkey for many years H.influenzae has not been isolated in cerebrospinal fluid (CSF) specimens. In order to show the bacteria involved in ABM in our hospital and to see the role of H.influenzae, we investigated the CSF of 59 patients with bacterial meningitis using Gram and Wayson stains, culture and latex agglutination techniques. The agents were determined in 38 (64.4%) specimens by using culture positivity in 30 (50.8%), and latex or stain positivity in eight (13.6%) specimens. The microorganisms causing ABM included S.pneumoniae (25.6%), gram-negative enteric bacillI (17.9%), N.meningitis (12.8%), alpha hemolytic streptococci (10.3%), H.influenzae (10.3%), nonfermentative gram-negative bacillI (5.1%), candida spp. (5.1%), group B streptococci (2.6%), coagulase negative staphylococci (2.6%), S.aureus (2.6%) and pseudomonas spp. (5.1%). In this study it has been shown that H.influenzae can cause ABM in Turkish children. Multicentric studies from different parts of Turkey will be helpful in showing the real incidence in our country.

摘要

急性细菌性脑膜炎(ABM)是儿童死亡和神经损伤的重要原因。确定病原体对于患者治疗和预防措施都非常重要。流感嗜血杆菌、脑膜炎奈瑟菌和肺炎链球菌是ABM的三种主要病原体。在土耳其,多年来脑脊液(CSF)标本中未分离出流感嗜血杆菌。为了明确我院ABM所涉及的细菌并了解流感嗜血杆菌的作用,我们采用革兰氏染色、魏森染色、培养及乳胶凝集技术对59例细菌性脑膜炎患者的脑脊液进行了研究。通过培养阳性在30例(50.8%)标本中确定了病原体,通过乳胶或染色阳性在8例(13.6%)标本中确定了病原体。引起ABM的微生物包括肺炎链球菌(25.6%)、革兰氏阴性肠杆菌(17.9%)、脑膜炎奈瑟菌(12.8%)、甲型溶血性链球菌(10.3%)、流感嗜血杆菌(10.3%)、非发酵革兰氏阴性杆菌(5.1%)、念珠菌属(5.1%)、B组链球菌(2.6%)、凝固酶阴性葡萄球菌(2.6%)、金黄色葡萄球菌(2.6%)和假单胞菌属(5.1%)。本研究表明,流感嗜血杆菌可导致土耳其儿童发生ABM。来自土耳其不同地区的多中心研究将有助于明确我国的实际发病率。

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