摘要
目的：了解神经外科术后患者凝固酶阴性葡萄球菌（ CoNS）感染的菌群分布与耐药性。方法连续收集2013年1月至2015年12月首都医科大学附属北京天坛医院神经外科术后患者脑脊液培养阳性的CoNS，根据美国疾病预防控制中心的相关标准，对感染菌与污染菌进行判断，并对菌株分布和感染菌株的耐药情况进行分析。结果共送检脑脊液样本19756份，分离出细菌1386株，其中CoNS 650株（46．9％）。650株CoNS中，130株（20．0％）被列为感染菌，其中，表皮葡萄球菌所占的比例最高，为59．2％（77／130），其后依次为人葡萄球菌（18／130，13．8％）、溶血葡萄球菌（11／130，8．5％）和头状葡萄球菌（9／130，6．9％）等，余520株为污染菌。药敏试验结果显示，130株感染病原菌中，耐甲氧西林凝固酶阴性葡萄球菌（MR-CoNS）所占的比例为79．1％（103／130），77株表皮葡萄球菌中，67株为MR-CoNS（87．0％）。所有菌株对万古霉素和利奈唑胺的敏感性均较高，其中表皮葡萄球菌对这两种药物的敏感率均大于90．0％。结论神经外科术后患者脑脊液中CoNS的分离率较高，且以表皮葡萄球菌感染为主。多数菌株为MR-CoNS，但对万古霉素和利奈唑胺的敏感性均较高，遂这两种药物可作为临床治疗的首选。
Objective To investigate the distribution and antimicrobial resistance of Coagulase-negative staphylococci （ CoNS） isolated from cerebrospinal fluids in neurosurgical patients.Methods CoNS strains isolated from cerebrospinal fluids of neurosurgical patients were collected from Beijing Tiantan Hospital of Capital Medical University during January 2013 and December 2015.CoNS infection was＆amp;nbsp;diagnosed according to the standards of US Centers for Disease Control and Prevention, and the distribution and antimicrobial resistance of pathogenic CoNS strains were analyzed. Results A total of 19 756 cerebrospinal fluid specimens were collected and 1 386 bacterial strains were isolated, in which 650 （46.9%） were CoNS.Among 650 CoNS strains, 130 were diagnosed as the pathogen, and the top 4 CoNS species were Staphylococcus epidermidis （77/130, 59.2%）, Staphylococcus hominis （18/130, 13.8%）, Staphylococcus haemolyticus （11/130, 8.5%） and Staphylococcus capitis （9/130, 6.9%）.The rest 520 CoNS strains were contaminating strains.According to antimicrobial susceptibility test, there were 103 strains of methicillin-resistant CoNS （MR-CoNS） accounting for 79.1% （103/130）.And among 77 Staphylococcus epidermidis isolates, 67 were MR-CoNS strains （87.0%） .More than 90.0%Staphylococcus epidermidis isolates were sensitive to vancomycin and linezolid, and the rest CoNS strains were also highly sensitive to these two antibacterial agents.Conclusions CoNS plays an important role in post-surgery infection in neurosurgical patients, and Staphylococcus epidermidis is the dominant CoNS species.Most CoNS strains are methicillin-resistant, but are highly sensitive to vancomycin and linezolid.
出处
《中华临床感染病杂志》
2016年第4期355-358,共4页
Chinese Journal of Clinical Infectious Diseases
基金
“十二五”国家科技支撑计划（2013BA117B00）
北京市卫生系统高层次卫生技术人才培养计划项目（2013-3-052）
关键词
葡萄球菌
表皮
凝固酶阴性葡萄球菌
脑脊髓液
中枢神经系统细菌感染
Staphylococcus epidermidis
Coagulase-negative staphylococci
Cerebrospinal fluid
Central nervous system bacterial infections
