几内亚科纳克里CHU Donka国立医院儿科儿童脑膜炎病原菌的流行病学特征和抗生素敏感性分析

Taliby Dos Camara, A. Makanéra, Demba Magassouba, Alpha Ousmane Barry
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摘要

前言:脑膜炎是热带国家的一个主要公共卫生问题目的:确定科纳克里东卡国立医院儿童中与脑膜炎有关的细菌对抗生素的敏感性。方法:这是一项前瞻性和描述性横断面研究,于2022年1月20日至4月20日进行。在不同的琼脂培养基上培养110份疑似儿童脑脊液样本(CSF)。结果:13份样品呈阳性。鉴定出三种不同的细菌:肺炎链球菌(54%=7/13)、流感嗜血杆菌b(31%=4/13)和大肠杆菌(15%=2/13)。雄性居多,性别比(M/F) 1.6。Ratoma公社的代表最多,占36%。临床表现以发热(54%)、呕吐(35%)、脑膜僵硬(20%)、惊厥(24%)、头痛(27%)为主。所有肺炎链球菌对左氧氟沙星和氧氟沙星敏感(100%),其中对阿米卡星敏感(57%),妥布霉素和呋喃妥英敏感(43%),庆大霉素敏感(29%)。对于流感嗜血杆菌,75%的菌株对庆大霉素、妥布霉素、环丙沙星、左氧氟沙星和氧氟沙星敏感,而对阿米卡星的敏感性为50%。最后,所有大肠杆菌菌株对环丙沙星、左氧氟沙星、氧氟沙星和呋喃妥英均敏感,而对阿米卡星和妥布霉素敏感的菌株仅占50%。结论:本研究发现儿童脑膜炎与三种细菌有关,其中以肺炎链球菌为主。喹诺酮类和氨基糖苷类是这些菌株中活性最高的抗生素科。研究人群由儿童组成,事实上,喹诺酮类药物不推荐用于这类患者,氨基糖苷类药物应被选择用于儿童的经验治疗。然而,脑膜炎病例的治疗需要在可能的情况下根据抗生素检查结果进行抗生素治疗。
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Epidemiological Aspect and Antibiotic Susceptibility Profile of Bacteria Responsible for Meningitis in Children in the Pediatrics Department of the CHU Donka National Hospital of Conakry, Guinea
Introduction: Meningitis represents a major public health problem in the tropical countries Objective: To determine the sensitivity to antibiotics of bacteria associated with meningitis in children at Donka National Hospital in Conakry. Methods: This is a prospective and descriptive cross-sectional study conducted from January 20th to April 20th, 2022. A total of 110 cerebrospinal fluids samples (CSF) from suspected children were cultured on different agar media.  Results: The results showed that 13 samples were positive. Three different bacterial species were identified: Streptococcus pneumoniae (54%=7/13), Hemophilus influenzae b (31%=4/13) and Escherichia coli (15%=2/13). Males predominated, with a sex ratio (M/F) of 1.6. The commune of Ratoma was the most represented with 36%. The most clinical manifestations were fever (54%), vomiting (35%), meningeal stiffness (20%), convulsion (24%) and headache (27%). All the Streptococcus pneumoniae strains were susceptible to levofloxacin and ofloxacin (100%), while 57% of these strains were susceptible to amikacin, 43% to tobramycin as well as to nitrofurantoin and 29% to gentamicin. For Hemophilus influenzae, 75% of the strains were susceptible to gentamicin as well as to tobramycin, ciprofloxacin, levofloxacin, and ofloxacin, while the susceptibility to amikacin was 50%. Finally, all Escherichia coli strains were sensitive to ciprofloxacin, levofloxacin, ofloxacin and nitrofurantoin, while only 50% of these strains were susceptible to amikacin and tobramycin. Conclusion: This study showed that three bacterial species were associated to meningitis in children, of which Streptococcus pneumoniae was mainly encountered.  Quinolones and aminoglycosides were the most active antibiotic families on these strains studied. The study populations being made up of children and the fact that quinolones are not recommended in this category of patients, aminoglycosides should be chosen for the empirical treatment of children. However, the treatment of cases of meningitis requires antibiotic treatment whenever possible based on the results of an antibiogram.
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