Table of Contents

HK J Paediatr (New Series)
Vol 24. No. 3, 2019

HK J Paediatr (New Series) 2019;24:127-134

Original Article

Escherichia coli Meningitis in Neonatal Intensive Care Units: A Five Years Study
初生兒深切治療部(NICU)大腸桿菌性腦膜炎:一項五年研究

KK Chik, WK To, K Luk, B Lam, CC Shek, C Tse, D Ng


Abstract

Introduction: Neonatal meningitis causes severe morbidity. The incidence of ampicillin-resistant Escherichia coli (E. coli) meningitis was reported to be increasing in overseas neonatal intensive care units (NICUs) recently. This is the first local study to investigate E. coli neonatal meningitis. Choice of empirical antibiotics for intrapartum period and neonates will be discussed. Methods: Retrospective study was performed in 2 NICUs between 1st January 2011 and 31st May 2016. Neonates with E. coli meningitis were included. Demographic data, laboratory results, antibiotics use and antimicrobial susceptibilities were reviewed. Results: Eleven neonates were identified and 55% had early-onset (EO) meningitis. Ninety-one percent of E. coli isolates were ampicillin-resistant. Twenty-seven percent were extended-spectrum-beta-lactamase (ESBL) producing and all were isolated in EO meningitis group. Use of intrapartum ampicillin and ESBL-E. coli infection in neonates showed no statistical significance. Conclusions: The risk of ampicillin-resistant E. coli meningitis in neonates continues despite of using intrapartum antibiotics in high risk group. Choice of intrapartum antibiotic and empirical treatment of neonatal sepsis has an urgent need to be reviewed.

簡介:新生兒腦膜炎可引起嚴重的併發症。近年,國外NICU對氨芐青黴素耐藥的大腸桿菌性腦膜炎的發病率呈上升趨勢。本研究是本地區首次對新生兒大腸桿菌性腦膜炎進行系列調查,產時和新生兒期經驗性抗生素的選擇是討論重點。研究方法:本研究對2011.1.1-2016.5.31期間2家NICU的病例進行回顧性分析,主要納入的對象為新生兒大腸桿菌性腦膜炎患兒。主要分析了人口統計學資料、實驗室檢測結果、抗生素使用情況和抗菌藥物敏感性等資料。結果:11名新生兒被確診為大腸桿菌性腦膜炎,其中55%患兒為早發型腦膜炎。91%的大腸桿菌分離菌株對氨芐青黴素耐藥。27%菌株可產生廣譜─內醯胺酶(ESBL),且均在早發型腦膜炎患兒發現。產時使用氨芐青黴素與新生兒期產ESBL-大腸桿菌感染無明顯相關性。結論:儘管高危人群使用產時抗生素,新生兒發生耐氨青黴素的大腸桿菌性腦膜炎的風險仍然存在。新生兒出現敗血症時選擇使用哪種抗生素和經驗性治療極待進一步研究。

Keyword : Antibiotic resistance; Escherichia coli; Neonatal meningitis

關鍵詞:抗生素耐藥性、大腸桿菌、新生兒腦膜炎

 
 

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