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Trends in pediatric bacterial meningitis in Japan (2003-2004)

机译：日本小儿细菌性脑膜炎的趋势（2003-2004年）

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摘要

We surveyed the epidemiology of pediatric bacterial meningitis between January 2003 and December 2004 in Japan, with the following results: Bacterial meningitis cases numbered 233 (132 boys, 98 girls, and 3 unidentified), equivalent to 1.13-1.6 children of 1000 hospitalized in pediatrics per year. The age distribution for the infections was the highest under 1 year of age, decreasing with increasing age. Haemophilus influenzae was the most common pathogen, followed by Streptococcus pneumoniae, group B streptococcus, and Escherichia coli. The relationship between causactive pathogens and age distribution was as follows: group B. streptococcus and E. coli were major pathogens below 4 months of age and H. influenzae and S. pneumoniae were major pathogens above 4 months of age. Susceptibility tests at each facility demonstrated that 65.0% of H. influenzae isolates and 83.0% of S. pneumoniae isolates in 2004 were drug-resistant. Ampicillin and cephem antibiotics are currently effective against GBS, E. coli and Listeria so a combination of ampicillin and cephem antibiotics is used first line at many facilities for patients below 4 months of age. A combination of carbapenem which showed effective against PRSP and cephem which showed effective against H. influenzae is the first choice in childhood bacterial meningitis for patients above 4 months of age.
机译：我们调查了2003年1月至2004年12月在日本的小儿细菌性脑膜炎的流行病学，结果如下：细菌性脑膜炎病例共233例（132例男孩，98例女孩和3例身份不明），相当于1.13-1.6名1000例儿科儿童住院每年。感染的年龄分布在1岁以下最高，随年龄增加而降低。流感嗜血杆菌是最常见的病原体，其次是肺炎链球菌，B组链球菌和大肠杆菌。致病性病原体与年龄分布之间的关系如下：B.链球菌和大肠杆菌是4个月以下的主要病原体，流感嗜血杆菌和肺炎链球菌是4个月以上的主要病原体。每个机构的药敏测试表明，2004年有65.0％的流感嗜血杆菌分离株和83.0％的肺炎链球菌分离株具有耐药性。氨苄青霉素和头孢类抗生素目前对GBS，大肠杆菌和李斯特菌有效，因此在许多机构中，一线使用氨苄青霉素和头孢类抗生素的组合适用于4个月以下的患者。对于4个月以上的患者，在儿童细菌性脑膜炎中首选使用碳青霉烯类药物（对PRSP有效）和对头孢菌素（对流感嗜血杆菌有效）的首选。

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