广西南宁市5岁以下儿童细菌性脑膜炎病原学研究

目的 了解南宁市5岁以下儿童细菌性脑膜炎的病原学特点和致病菌的药物敏感性情况。方法2000年11月至2002年12月，在南宁市(含邕宁、武鸣县)所在乡镇卫生院以上的医疗机构进行监测，对发现疑似脑膜炎患儿采集脑脊液和血液进行细菌培养和采用kIrbv-Bauer纸片扩散法对病原菌进行药物敏感试验。结果 共检测采自1272例病例的1212份脑脊液标本和1193份血标本。分离出63株致病菌，其中从脑脊液标本中检出23株，从血液中检出40株。脑脊液和血液培养栓出最多的病原菌基本上一致，葡萄球菌最多，其次是肺炎双球菌、流感嗜血杆菌、肠杆菌科细菌。葡萄球菌对万古霉素、庆大霉素、苯唑西林及环丙沙星敏感率均在80％以上，而对青霉素和红霉素耐药率很高。沙门菌、大肠杆菌、阴沟肠杆菌等肠杆菌科细菌对环丙沙星、头孢菌素的敏感性较高。蛄论细菌性感染是南宁市婴幼儿脑膜炎致病因素之一。抗菌药物的选择使用应根据细菌药敏结果，以提高疗效，防止耐药性发生。

Etiological study on the bacterial meningitis in children under 5 years of age in Nnnning City, Guangxi

Objective To characterize etiological agents causing childhood bacterial meningitis and to describe patterns of antibiotic susceptibility among isolates form patients with meningitis. Methods A prospective,population-based surveillance for bacterial meningitis was conducted among childrem <5 years of age living in Nanning,Wuming and Yongning counties,from November 2000 through December 2002.Cerebrospinal fluid (CSF) and blood specimens were obtained for bacterial culture from patients with suspected meningitis.Antibiotic susceptibility was tested for isolates by Kirby-Bauer method. Results A total of 63 isolates were identified including 23 from 1 212 CSF specimens and 40 from 1 193 blood cultures obtained from 1 272 cases.During the surveillance years,staphylococus species accounted for the largest proportion of meningitis (39.1%),follwed by pneumococcus (13.0%) and H.influenzae(13.0%).More than 80% of staphylococcal isolates were sensitive to vancomycin,gentamycin and ciprofloxacin,but highly resistant to penicillin and erythromycin.Sensitivity to ciprofloxacin and first-,second-,and third-cephalosporins was common among enterobacteriaceae family. Conclusion There results suggest the bacterial infection present and important cause of children morbidity in Guangxi.Antimicrobial regimen should be based on drug susceptibility results.