Distribution and Drug Resistance of Cerebrospinal Fluid-Positive Strains in Children
Objective To understand the distribution of pathogenic bacteria and resistance to commonly used antimicrobial drugs in the cerebrospinal fluid of children.Methods Cerebrospinal fluid isolates from the Children's Hospital Affiliated to Zhengzhou University were collected from January 2017 to December 2021,and pathogenic bacteria were identified by matrix assisted laser desorption ionization time flight mass spectrometry,and drug sensitivity experiments were performed by Phoenix 100,Vitek-2 microbiological analyzer and paper diffusion method,and drug sensitivity results were interpreted according to standards of American Association for the standardization of clinical laboratories,and retrospective drug resistance analysis was performed by WHONET 5.6 software.Results A total of 314 pathogenic bacteria were collected from cerebrospinal fluid isolates,with 204(65.0％)predominantly Gram-positive bacteria.The top five pathogens were coagulase-negative Staphylococcus 92 strains(29.2％),Enterococcus 44 strains(14.0％),Escherichia coli 32 strains(10.2％),Klebsiella pneumoniae 21 strains(6.7％),and Streptococcus pneumoniae 18 strains(5.7％)in order.The number of isolated strains was higher in the second and third quarters,and 147 strains(46.8％)were the most common in infants within 1 year of age.The detected departments were mainly neurosurgery 77 strains(24.5％),neonatology 70 strains(22.3％),and neurology 46 strains(14.6％).Multi-drug resistant bacteria were detected 149 strains(47.5％),including 69 strains methicillin-resistant coagulase negative staphylococci(MRCNS),18 strains extended-spectrum β-lactamase-producing Enterobacteriaceae(ESBLs)and 18 strains carbapenem-resistant Enterobacteriaceae(CRE).There were no significant differences in the incidence of multiple drug resistance among age groups,between genders,or between years(P＞0.05),and the incidence of multiple drug resistance was different between different departments(P＜0.001).Conclusion The pathogenic bacteria isolated from cerebrospinal fluid were mainly Gram-positive bacteria,and the infection was mainly concentrated in infants within 1 year of age,and the detection of carbapenem-resistant Klebsiella pneumoniae should be emphasized for multi-drug resistant strains.
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