Analysis of pathogenic distribution and drug resistance in 156 neonates with purulent meningitis

Objective To analyse the pathogenic distribution and drug resistance in 156 hospitalized neonates with purulent meningitis from January,2000 to December,2005,so as to provide the basis for the rational application of antimicrobial agents in clinic.Methods Cerebral spinal fluid specimen was inoculated on blood agar and high osmolar agar culture medium,bacteria were identified by an automated API system;antimicrobial susceptibility tests were performed by Kirby-Bauer method,extended spectrum β-lactamases(ESBLs) were detected by double-disk diffusion method.Results One hundred and fifty-six strains of aerobic bacteria were isolated,42(26.92%) of which were gram-negative bacilli,the main gram-negative bacilli were Escherichia coli(11 strains,26.19%),Acinetobacter spp.(5 strains,11.91%),Klebsiella pneumoniae(4 strains,9.52%),Proteus(4 strains,9.52%),12(28.57%) strains produced ESBLs;103(66.03%) of the 156 strains were gram-positive cocci,Staphylococcus epidermidis(56 strains,54.37%),Staphylococcus haemolyticus(7 strains,6.80%) were the main gram-positive cocci;11(7.05%) were the other bacteria.The isolation rate of gram-negative bacilli during 2003~2005 was 35.14%,which was higher than 19.51% during 2000-2002(χ2=4.83,P0.05).Gram-negative bacilli were sensitive to imipem,ceftriaxone and cefoperazone;and the gram-positive cocci were sensitive to cefotaxime,cefoperazone and ceftriaxone.Conclusion The main pathogens of neonatal purulent meningitis are Staphylococcus epidermidis,Escherichia coli and Staphylococcus haemolyticus,the isolation rate of gram-negative bacilli are in rising trend year by year,antimicrobial agents should be selected rationally based on the results of the antimicrobial susceptibility test result.