ABSTRACT
Objective:To investigate the distribution of pathogen species isolated from cerebrospinal fluid culture (CSF) in children and analyze the antibiotic-resistance of the main isolates in vitro, which provides reference for interpreting the pathogens and choosing antibiotics in empiric therapy for pediatric patients. Methods:The results of cerebrospinal fluid culture were collected by checking laboratory information system of the Children′s Hospital of Zhejiang University and the clinical characteristics of these children were analyzed retrospectively by checking electronic medical record system.Results:A total of 1 312 isolates were detected, including 1 294 isolates of bacteria and 18 isolates of fungi. A total of 497 (37.9%) isolates were pathogenic microorganisms, of which 288 (57.9%) isolates were gram-positive, 200 (40.3%) isolates were gram-negative, and 9 (1.8%) isolates were fungi. The top 5 pathogens were Escherichia coli (102 isolates, 20.5%), Streptococcus pneumoniae (64 isolates, 12.9%), Streptococcus agalactiae (52 isolates, 10.5%), Enterococcus faecium (33 isolates, 6.6%) and Staphylococcus aureus (28 isolates, 5.6%). Most of the Streptococcus pneumoniae strains were isolated from children more than 1 year old (76.6%, 49/64), while the other top 4 bacteria were mainly isolated from infants less than 1 year old, with the rate of 95.1%(97/102) for Escherichia coli, 98.1%(51/52) for Streptococcus agalactiae, 81.8%(27/33) for Enterococcus faecium and 71.4% (20/28) for Staphylococcus aureus. A total of 815 (62.1%) isolates were considered to be contaminated pathogens according to the analysis on clinical manifestations and other laboratory findings in CSF, and coagulase-negative Staphylococcus (680 isolates), Micrococcus (50 isolates), Corynebacterium (28 isolates) and Enterococcus faecium (23 isolates), which accounted for 41.1% (23/56) of the total detected Enterococcus faecium, were the top 4 contaminated bacteria. During the study period, the isolation rate of the pathogenic microorganisms increased year by year (χ2=34.84, P<0.001), while the isolation rate of the contaminated pathogens, which detected mainly in summer and autumn, decreased year by year (χ2=13.26, P<0.001). Conclusions:The predominant bacteria causing pediatric purulent meningitis were Escherichia coli, Streptococcus pneumoniae, Streptococcus agalactiae, Enterococcus faecium and Staphylococcus aureus. Coagulase-negative Staphylococcus, Micrococcus, Corynebacterium and Enterococcus faecium were common contaminated bacteria in CSF culture, therefore clinicians should interpret the results of CSF culture cautiously according to the bacterial species and clinical manifestations.
ABSTRACT
By analyzing the covariance of maintenance data in Hospital Information System,this paper points out the wrong operations of Hospital Information System and puts forward a series of valid solutions including software improvement,timely communication with users,reinforcement of operator training.
ABSTRACT
AIM:To observe the therapeutic effect of aescine in the treatment of lumbar intervertebral disc prolapse(LIDP).METHODS:One hundred and seventy-six patients with LIDP were divided into 2 groups:aescine group of 80 patients［M56,F24;age(43±s17)a,course of disease(7.4±2.3) mo］ received conventional therapy plus aescine 10-15 mg in 5 % glucose or 0.9 % sodium chloride injection 250 mL,iv,drip,bid,for 7-10 d.Control group of 96 patients［M57,F39;age(42±16)a,course of disease(7±3)mo］only received conventional therapy,including towing,massage,acupuncture,anodyne.Therapeutic effects of both groups were compared after 4 wk.RESULTS:The total effective rate of aescine and control group was 95 % and 81 %,respectively(P＜0.05),while in those course of disease less than 0.5 a the effective rate was 97 % and 85 %,respectively(P＜0.05).No obvious adverse reactions occoured. CONCLUSION:Aescine is safe and effective for the treatment of LIDP.The shorter the disease course is,the better the therapeutic effects are.