标题：新生儿化脓性脑膜炎病原菌构成及耐药性分析

      作者：杨梅，陈桥，孙正刚    (达州市中西医结合医院检验科 四川 达州 635000)

      卷次： 2017年28卷15期

      【摘要】 目的 分析新生儿化脓性脑膜炎病原菌构成情况及耐药性情况。方法 选取达州市中西医结合医院2013年3月至2015年3月收治的142例化脓性脑膜炎新生儿的脑脊液培养结果进行研究，比较分析其病原菌构成和耐药性情况。结果 142例化脓性脑膜炎新生儿脑脊液病原菌构成：双菌株2例，单菌株140例，其中革兰阴性细菌100株(68.97%)，革兰阳性细菌38株(26.21%)，真菌7株(4.83%)。革兰阳性细菌中腐生葡萄球菌、表皮葡萄球菌、粪肠球菌以及屎肠球菌等菌种对复方新诺明、氨苄西林、红霉素以及头孢西丁等抗生素耐药，但未检出对万古霉素和替考拉宁耐药的菌种。革兰阴性细菌中大肠埃希菌、肺炎克雷伯菌、黏质沙雷菌等菌种对所研究抗生素耐药性较高，其中大肠埃希菌对复方新诺明、氨苄西林等抗生素的耐药率甚至达到 80%以上，而整个研究未发现对美罗培南耐药的菌种。结论 新生儿化脓性脑膜炎病原菌检出率主要以革兰阴性菌为主，且致病菌的耐药性严重。
      【关键词】 大肠埃希菌；化脓性脑膜炎；病原菌构成；耐药性
      【中图分类号】 R722.1 【文献标识码】 A 【文章编号】 1003—6350（2017）15—2486—04

Pathogen composition and drug resistance in neonates with purulent meningitis.
YANG Mei, CHEN Qiao, SUNZheng-gang. Department of Clinical Laboratory, Sichuan Dazhou Hospital of Integrated Traditional Chinese and WesternMedicine, Dazhou 635000, Sichuan, CHINA
【Abstract】 Objective To analyze the pathogen composition and drug resistance of neonatal purulent meningitis.Methods Cerebrospinal fluid samples of 142 neonates with purulent meningitis of in our hospital from March 2013 toMarch 2015 were collected and cultured. The pathogen composition and drug resistance were compared. Results Amongthe 142 cases, 2 were infected by two pathogensand one was infected by one pathogen, with Gram-negative bacteria in100 strains (68.97%), Gram-positive bacteria in 38 strains (26.21%), fungi in 7 strains (4.83%). Saprophytic staphylococ-cus, Staphylococcus epidermidis, Enterococcus faecalis and Enterococcus faecium of Gram-positive bacteria were resistant toantibiotics such as cotrimoxazole, ampicillin, erythromycin and cefoxitin, but no strain showed resistance to vancomycinand teicoplanin. Escherichia coli, Klebsiella pneumonia, Serratia marcescens of Gram-negative bacteria were highly resistantto antibiotics detected, of which Escherichia coli showed a resistance rate of more than 80% to compound neopanamineand ampicillin, and no strain showed resistance to meropenem. Conclusion Pathogens of neonatal purulent meningitisdetected is mainly Gram-negative bacteria, and the drug resistance of the pathogenic bacteria is serious.
      【Key words】 Escherichia coli; Purulent meningitis; Pathogen composition; Drug resistance·论 著·doi:10.3969/j.issn.1003-6350.2017.15.023基金项目：四川省科技支撑计划(编号：2015SZ4576)