神经外科术后颅内感染脑脊液病原菌及其药敏变迁分析
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Pathogens of cerebrospinal fluid and their drug susceptibility in patients with postoperative intracranial infection in neurosurgery
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    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。

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    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 Decem-ber 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%) G- bacteria. 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%). Super-infection in bacterial meningitis was observed in 8 patients. Conclusions:G+ bacteria are more common in neurosurgical patients,es-pecially 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.

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罗孝全,赵贯建,程 远,陈维福.神经外科术后颅内感染脑脊液病原菌及其药敏变迁分析[J].重庆医科大学学报,2014,38(4):478-482

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  • 在线发布日期: 2014-09-24
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