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Objective:To study the distribution and antibiotics resistance of the main pathogens of neonatal purulent meningitis in different regions of China.Methods:A retrospective descriptive clinical epidemiological study was conducted in children with neonatal purulent meningitis which admitted to 18 tertiary hospitals in different regions of China between January 2015 to December 2019. The test results of blood and cerebrospinal fluid, and drug sensitivity test results of the main pathogens were collected. The distributions of pathogenic bacteria in children with neonatal purulent meningitis in preterm and term infants, early and late onset infants, in Zhejiang Province and other regions outside Zhejiang Province, and in Wenzhou region and other regions of Zhejiang Province were analyzed. The chi-square test was used for statistical analysis.Results:A total of 210 neonatal purulent meningitis cases were collected. The common pathogens were Escherichia coli ( E. coli)(41.4%(87/210)) and Streptococcus agalactiae ( S. agalactiae)(27.1%(57/210)). The proportion of Gram-negative bacteria in preterm infants (77.6%(45/58)) with neonatal purulent meningitis was higher than that in term infants (47.4%(72/152)), and the difference was statistically significant ( χ2=15.54, P=0.001). There were no significant differences in the constituent ratios of E. coli (36.5%(31/85) vs 44.8%(56/125)) and S. agalactiae (24.7%(21/85) vs 28.8%(36/125)) between early onset and late onset cases (both P>0.05). The most common pathogen was E. coli in different regions, with 46.7%(64/137) in Zhejiang Province and 31.5%(23/73) in other regions outside Zhejiang Province. In Zhejiang Province, S. agalactiae was detected in 49 out of 137 cases (35.8%), which was significantly higher than other regions outside Zhejiang Province (11.0%(8/73)). The proportions of Klebsiella pneumoniae, and coagulase-negative Staphylococcus in other regions outside Zhejiang Province (17.8%(13/73) and 16.4%(12/73)) were both higher than those in Zhejiang Province (2.9%(4/137) and 5.1%(7/137)). The differences were all statistically significant ( χ2=14.82, 12.26 and 7.43, respectively, all P<0.05). The proportion of Gram-positive bacteria in Wenzhou City (60.8%(31/51)) was higher than that in other regions in Zhejiang Province (38.4%(33/86)), and the difference was statistically significant ( χ2=6.46, P=0.011). E. coli was sensitive to meropenem (0/45), and 74.4%(32/43) of them were resistant to ampicillin. E. coli had different degrees of resistance to other common cephalosporins, among which, cefotaxime had the highest resistance rate of 41.8%(23/55), followed by ceftriaxone (32.4%(23/71)). S. agalactiae was sensitive to penicillin, vancomycin and linezolid. Conclusions:The composition ratios of pathogenic bacteria of neonatal purulent meningitis are different in different regions of China. The most common pathogen is E. coli, which is sensitive to meropenem, while it has different degrees of resistance to other common cephalosporins, especially to cefotaxime.
RÉSUMÉ
OBJECTIVE:To observe therapeutic efficacy and safety of Xiaoer jiegan granules with Ribavirin in the treatment of acute upper respiratory tract infection. METHODS:98 patients with upper respiratory tract infection were randomly divided into obser-vation group and control group with 49 cases in each group. Control group was given Ribavirin injection for routine upper respiratory tract antiviral therapy,10-15 mg/kg,added into 5% Glucose injection 250 ml,ivgtt,qd. Observation group was given Xiaoer jiegan granules,1g/time for 1-3 year-old children,2g/time for 4-6 year-old children and 3 g/time for 7-9 year-old,tid. A treatment course of 2 groups lasted for 5 days,both received 2 courses of treatment. Clinical efficacy,cough and other symptoms score,ADR were ob-served in 2 groups. RESULTS:The effective rate of observation group (97.96%) was higher than that of control group (87.76%), with statistical significance(P0.05);after treatment, the scores of fever and cough and other symp-toms in observation group were lower than in control group,with statistical significance(P<0.05). The incidence of ADR in the ob-servation group(6.12%)was significantly lower than in control group(22.45%),with statistical significance(P<0.05). CONCLU-SIONS:Xiaoer jiegan granule with Ribavirin is effective in the treatment of acute upper respiratory tract virus infection,and can im-prove fever,cough and other clinical symptoms,so as to promote better conditions and reduce the occurrence of ADR.
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Objective: To explore the influence of lipid emulsion of early intravenous nutrition on gain in weight and observe the side effect in very low birth weight(VLBW) infants.Methods: The infants with birth weight below 1 500 g were randomly divided into the treatment group and the control group.The treatment group received intravenous nutrition with fat emulsion within 24 hours after birth,and the control group received intravenous nutrition without fat emulsion.The weight,biochemical parameters and complication were observed after 10 days.Results:The daily weight gain of treatment group was significantly higher than the cotrol group.The risks of azotemia,high bilirubin and cholestasis were not increased in treatment group.The incidences of complication between the two groups showed no significant difference(P>0.05).Conclusion: The use of fat emulsion in early intravenous nutrition can shorten the average hospital stay,promote the weight gain,and is safe.