Etiological Analysis Of 78 Newborns With Purulent Meningitis

Background and purposeTheincidence,clinical characteristics,bacteria composing and thereby the drug susceptibility of neonatal purulent meningitis,which come from eight years cases of South China University Affiliated Chenzhou Hospital,were analyzedto reveal the distribution and the drug resistance of neonatal purulent meningitis pathogen inChenzhou district,and to provide a reference basis for clinic.Methods Theauthorretrospectively summarized the pediatric purulent meningitis clinical data between January 2008 to December of South China University Affiliated Chenzhou Hospital,and analyzed the composing characteristics and the drug resistance of the dominating pathogenic bacteria,and analyzed the relationships of gestational age,time of onset of illness,community infection and nosocomial infection to the distribution of pathogenic bacteria.Results1.There 78 strains of pathogens bacteriawere found,with 43strains of gram positive bacteria(G~+bacteria)(55.1%),and 35 strains of gram negative bacteria(G~–bacteria)(44.9%).The top six bacteria,in the order:E.coli(19 strains,24.4%);Coagulase-Negtive Staphylococci(CONS)(17 strains,21.8%);Streptococcus(10 strains,12.8%),Enterococcus(8 strains,10.3%),Glucose aureus golden(7 strains,9.0%),serratiamarcescens(6 strains,7.7%).2.Between case groups of the first 4 years and of the last 4 years,there was no significant difference in total strains number,and there was no significant difference in the composition of dominating pathogenic bacteria(P>0.05)except for Mr Charest bacteria(P<0.05).3.Compared the dominating pathogenic bacteria from early newborn and from late newborn,more strains number of CONS was found in the former than in the later,with a significant difference(P=0.046),and also,the number of E.colistrainswere higher in early newborn than in late newborn(P=0.002),but,the number of serratiamarcescens strains were higher in late newborn than in early newborn(P=0.048).4.Compared thebacteria composition between community infection cases and nosocomial infection cases,infecting of CONS in the former were higher than that of the later(P=0.033),while the infecting of serratiamarcescens were higher in the later than in the former(P=0.007).5.Compared the pathogen bacteria between cases with different gestational age,premature infants with gestational age<32 weeks have a high incidenceof serratiamarcescens infection,than infants with gestational age≥37 weeks(P=0.013).The comparing of the rest pathogen between groups found no statistical significance(P﹥0.05).6.To the aspect of Drug susceptibility,G~+bacteria were universally sensitive to vancomycin,the author did not check out the rina thiazole amine drug resistant strains.Staphylococcus was completely resistant to penicillin,and was resistant to oxacillin,erythromycin,andcefazolin,respectively.Streptococcusanddung enterococcus are generally sensitive to oxacillin.G~-bacteria was generally resistant to penicillin,such as ampicillin and cephalosporinand was high sensitive to aminoglycoside of amikacin,to quinolone and to carbapenems.E.coli was sensitive tocefperazone and sulbactam,and was resistant to the second generation and the third generations of cephalosporin.Serratia marcescens bacteria were resistant to antibiotic such as penicillin and cephalosporin,and were universally resistant to carbapenems such as meropenem and imipenem,and were high sensitive to antibotics such as amikacin,ciprofloxacin,and quinolones.Klebsiella pneumoniae were resistance to ampicillin,azlocillin,cefalotin,ceftazidime and cefotaxime,and were sensitive to piperacillin,tazobactam and imipenem.Conclusions:1.In recent 8 years,pathogen of neonatal purulent meningitis from Chenzhou Hospital were generally E.coli,CONS,andStreptococcus,,the distribution of pathogen was relate to gestational age,time of onset of illness,community infection and nosocomial infection,and clay Mr Charest bacteria had a tendency to increase in recent years.2.The pathogen of neonatal purulent meningitis were universally resistant to penicillin,and the G~+bacteria were universally sensitive to vancomycin,the author did not check out the rina thiazole amine drug resistant strains.G~-bacteria was generally resistant to penicillin,such as ampicillin and cephalosporin.and was high sensitive to aminoglycoside of amikacin,to quinolone and to carbapenems.