摘要
目的:探讨神经外科术后颅内感染脑脊液病原菌分布及药敏,为临床合理应用抗生素提供依据。方法:收集2008年1月至2012年12月术后颅内感染患者脑脊液标本510份,对病原菌分布及药敏进行回顾性分析。结果:共分离出病原菌114株,阳性率为22.35%,其中G+菌58株(50.88%),G-菌56株(49.12%),未发现真菌感染。位居前6位的病原菌分别为:凝固酶阴性葡萄球菌(28.95%),鲍曼不动杆菌(16.67%),肠球菌属(9.65%),铜绿假单胞菌(9.65%),肺炎克雷伯杆菌(6.14%)及金黄色葡萄球菌(5.26%)。对G+菌敏感的药物有:万古霉素、利奈唑胺、哌拉西林/他唑巴坦等,尚未发现万古霉素耐药菌株;对G-菌敏感的药物有:亚胺培南、哌拉西林/他唑巴坦、阿米卡星等。8例患者发生重叠颅内感染。结论:神经外科术后颅内感染病原菌以G+菌为主,但近年来,G-菌比例及种类显著增加,特别是鲍曼不动杆菌等多药耐药菌,需引起临床重视。
Objective：To analyze the distribution and drug susceptibility of bacteria isolated from cerebrospinal fluid（CSF） in patients who developed nosocomial meningitis following neurosurgical operation and to provide evidences for clinical treatment of meningitis. Methods ： Clinical data of pathogens and their drug susceptibility to antibiotics from CSF were collected from January 2008 to December 2012. Distribution and drug susceptibility of bacteria were analyzed retrospectively. Results：Positive rate of pathogens was 22.35 （114/510） from 510 CSF specimens. There were 114 strains of pathogens including 58 （50.88%） G＋ bacteria and 56（49.12%） Gbacteria. The most frequently isolated bacteria was coagulase-negative staphylococci（28.95% ）,followed by acinetobacter baumannii （ 16.67% ）, enterococcus spp. （ 9.65 % ） ,pseudomonas aeruginosa （ 9.65 % ）, klebsiella pneumoniae （ 6.14% ）, staphylococcus aureus. The active compounds against G^＋ bacteria were vancomycin（100%）, linezolid（95.92%）, piperacillin-tazobactam（88.89%）. The active compounds against G bacteria were imipenem （66.04%）, followed by piperacillin-tazobactam （59.46%）, amikacin （55.10%）. Superinfection in bacterial meningitis was observed in 8 patients. Conclusions：G＋ bacteria are more common in neurosurgical patients, especially coagulase-negative staphylococci, however, G- pathogens has increased recently, especially acinetobacter baumannii, therefore nosocomial meningitis pathogens should be considered in the choice of empirical antibiotic treatments.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2014年第4期478-482,共5页
Journal of Chongqing Medical University
关键词
脑脊液
病原菌
耐药性
药物敏感性
神经外科
术后
cerebrospinal fluid
pathogen
drug resistance
drug susceptibility
neurosurgery
postoperative
