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目的分析我院近5年神经外科颅内感染患者的脑脊液病原菌分布特点及耐药变化,为神经外科合理选用抗菌药物治疗颅内感染提供依据。方法利用病历系统查询并收集到2011至2015年神经外科66例颅内感染患者的脑脊液培养病原菌种类、数量、对抗菌药物敏感性等数据,分析该5年内病原菌的流行特点和药敏情况。结果 2011至2015年从我院神经外科颅内感染患者的脑脊液中分离、培养出病原菌112株,其中革兰阳性菌占56.25%,革兰阴性菌占43.75%。最常见的病原菌分别是表皮葡萄球菌(27.68%)、金黄色葡萄球菌(23.21%)、鲍曼不动杆菌(16.07%)和肺炎克雷伯菌(10.71%)。分离的革兰阳性菌与阴性菌均呈不同程度的耐药;金黄色葡萄球菌耐药率高,仅对利奈唑胺、万古霉素敏感率为100.00%;鲍曼不动杆菌对碳青霉烯类抗菌药物的耐药率已高于30%;肺炎克雷伯菌对常用抗菌药物耐药率低。结论引起神经外科颅内感染的细菌耐药性越来越严重,必需严密监测细菌耐药,规范预防和治疗用药。
Objective To analyze the distribution and drug resistance changes of cerebrospinal fluid pathogens in patients with intracranial infection of neurosurgery in the past five years in our hospital and provide the basis for rational use of antimicrobial agents in the treatment of intracranial infection in neurosurgery. Methods Sixty-six patients with intracranial infection in neurosurgery from 2011 to 2015 were enrolled in this study. The types and quantity of pathogens in cerebrospinal fluid culture and the sensitivity to antibiotics were collected. The epidemiological characteristics and drug susceptibility of pathogens in five years were analyzed. Results From 2011 to 2015, 112 strains of pathogens were isolated from cerebrospinal fluid of patients with intracranial infection of neurosurgery in our hospital. Among them, Gram-positive bacteria accounted for 56.25% and Gram-negative bacteria accounted for 43.75%. The most common pathogens were Staphylococcus epidermidis (27.68%), Staphylococcus aureus (23.21%), Acinetobacter baumannii (16.07%) and Klebsiella pneumoniae (10.71%) respectively. Gram-positive isolates and negative isolates were resistant to varying degrees of resistance; Staphylococcus aureus high resistance rate, only linezolid, vancomycin sensitivity was 100.00%; Acinetobacter baumannii Penicillium Ethylene antibacterial drug resistance rate has been higher than 30%; Klebsiella pneumoniae commonly used antimicrobial resistance rate is low. Conclusions The bacterial resistance to intracranial infection caused by neurosurgery is getting more and more serious. It is necessary to closely monitor bacterial resistance and standardize preventive and curative medication.