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目的探讨新生儿化脓性脑膜炎病原菌特征。方法选择2010年1月至2013年12月本院确诊为新生儿化脓性脑膜炎的住院患儿,分析化脓性脑膜炎的发生情况、微生物检查病原学特征及主要临床表现。结果共收治化脓性脑膜炎患儿454例,占同期住院患儿的2.4%(454/18 847)。其中早产儿75例,占同期住院早产儿的2.3%,足月儿318例,占同期住院足月儿的2.0%,过期产儿59例,胎龄不祥2例;诊断日龄≤7天136例(30.0%),8~28天318例(70.0%);阴道分娩311例,剖宫产143例。454例患儿均进行微生物检查,阳性122例(26.9%),其中血培养阳性94例(20.7%),脑脊液培养阳性19例(4.2%),血和脑脊液培养均阳性9例(2.0%)。血培养病原菌以表皮葡萄球菌居首位(46.0%),其次是大肠埃希菌(22.3%),脑脊液培养、血和脑脊液培养同时阳性的病原菌均以大肠埃希菌为主,分别占52.0%及44.0%。脑脊液培养阳性患儿临床表现较严重,均有抽搐。结论新生儿化脓性脑膜炎脑脊液培养病原菌以大肠埃希菌为主,脑脊液培养阳性患儿临床表现严重,预后不良。
Objective To investigate the characteristics of neonatal purulent meningitis pathogens. Methods From January 2010 to December 2013 in our hospital diagnosed as neonatal purulent meningitis inpatients, analysis of the occurrence of purulent meningitis, the etiological characteristics of microbiological examination and the main clinical manifestations. Results A total of 454 children with purulent meningitis were admitted, accounting for 2.4% (454/18 847) of the hospitalized children in the same period. Among them, 75 were premature children, accounting for 2.3% of hospitalized preterm infants in the same period, 318 full-term infants, accounting for 2.0% of full-term infants in the same period, 59 were overdue and 2 were ominous gestational age. (30.0%), 318 cases (70.0%) in 8 ~ 28 days, 311 cases of vaginal delivery and 143 cases of cesarean section. 454 children were examined by microbes, 122 cases (26.9%) were positive, of which 94 (20.7%) were positive for blood culture, 19 (4.2%) were positive for cerebrospinal fluid culture, 9 were positive for blood and cerebrospinal fluid culture (2.0% . Staphylococcus epidermidis (46.0%), followed by Escherichia coli (22.3%) were detected in blood-borne pathogens. Escherichia coli was the most common pathogens in cerebrospinal fluid culture and blood and cerebrospinal fluid culture, accounting for 52.0% And 44.0% respectively. Cerebrospinal fluid culture positive children with more serious clinical manifestations, have convulsions. Conclusion The pathogens of cerebrospinal fluid culture of neonatal purulent meningitis are mainly Escherichia coli. The clinical manifestations of cerebrospinal fluid positive children are serious with poor prognosis.