摘要
目的探索2009-2018年ESKAPE在神经外科医源性细菌性感染患者的流行病学与耐药性变迁。方法回顾性分析2009-2018年该院神经外科术后患者脑脊液培养阳性的6类耐药菌并分析其流行病学与耐药性。结果10年间,脑脊液培养阳性患者2781例,其中6类致病菌占24.5%,鲍曼不动杆菌、金黄色葡萄球菌与肺炎克雷伯菌的分离率高于屎肠球菌、铜绿假单胞菌与肠杆菌属。2009-2018年神经外科医源性感染金黄色葡萄球菌方面,耐甲氧西林金黄色葡萄球菌(MRSA)的构成比并未上升,碳青霉烯耐药肺炎克雷伯菌与鲍曼不动杆菌的比例上升明显,整体耐药率超过40.0%,万古霉素耐药屎肠球菌比例超过20.0%。结论近十年间,ESKAPE在神经系统医源性感染方面较为严重,尤其是碳青霉烯鲍曼不动杆菌(CRAB)、万古霉素肠球菌(VRE)、耐碳青霉烯类肠杆菌科细菌(CRE)等耐药菌的泛滥,使临床应对神经外科医源性细菌感染更为棘手。
Objective To explore the epidemiology and drug resistance changes of eskape in neurosurgery patients with iatrogenic bacterial infection from 2009 to 2018.Methods A retrospective analysis of six kinds of drug-resistant bacteria were analyzed retrospectively from 2009 to 2018 in cerebrospinal fluid of neurosurgery patients in Beijing Tiantan Hospital Affiliated to Capital Medical University.Results From 2009-2018,2781 isolates were separated from neurosurgical patients CSF.Among them,six kinds of pathogens accounted for 24.46%,Acinetobacter baumannii,Staphylococcus aureus and Klebsiella pneumoniae were the dominate bacteria.From 2009 to 2018,the constituent ratio of MRSA in neurosurgical did not increase,but the ratio of carbapenem-resistant K.pneumoniae and Acinetobacter baumannii increased significantly,and the overall resistance rate exceeded 40%.Vancomycin-resistant Enterococcus faecium ratio was more than 20%.Conclusion ESKAPE are quite serious in latrogenic infection of nervous system in the recent decade.In particular,the spread of resistant bacteria such as Carbapenem Acinetobacter baumannii(CRAB),Vancomycin Enterococcus(VRE),Carbapenem-resistant Enterobacteriaceae(CRE)has led to a clinical thorny problem in response to neurosurgical patients.
作者
黄泽玉
郑光辉
吕虹
张国军
HUANG Zeyu;ZHENG Guanghui;LYU Hong;ZHANG Guojun(Department of Clinical Laboratory,Beijing Tiantan Hospital Affiliated to Capital Medical University,Beijing 100070,China)
出处
《国际检验医学杂志》
CAS
2020年第11期1341-1346,共6页
International Journal of Laboratory Medicine
基金
北京市优秀人才青年骨干基金项目(2017000021469G270)。
