132份脑脊液细菌培养阳性菌株分布及耐药性分析

Analysis of pathogens and resistance to antibiotics from 132 cerebrospinal fluid specimens

目的 调查2009年1月至2010年12月住院患者常规送检的脑脊液培养结果及耐药状况,为临床预防感染和应用抗菌药物提供参考.方法 采用法国生物梅里埃公司全自动微生物分析仪VITEK 2 Compact进行细菌鉴定及药物敏感试验.结果 132株阳性菌株分离自1121份住院患者脑脊液标本,阳性率11.76％,其中革兰阴性菌80株（60.61％）,革兰阳性菌52株（39.39％）；排名前3位的病原菌依次为鲍曼不动杆菌45株（34.09％）,凝固酶阴性葡萄球菌45株（34.09％）,阴沟肠杆菌18株（13.64％）；革兰阴性杆菌对头孢哌酮/舒巴坦、阿米卡星和替加环素敏感,革兰阳性菌对万古霉素、米诺环素高度敏感.结论 脑脊液标本检出的病原菌以革兰阴性菌多见,以院内感染为主,耐药状况严重,提示临床应正确使用抗菌药物.

Objective To investigate the pathogenic results and drug resistance of bacteria isolated from cerebrospinal fluid specimens from January 2009 to December 2010 in order to provide evidence to prevent infection and use antibiotics accurately.Methods The bacteria identification and antimicrobial susceptibility were assayed by automatic bacteria culture device VIVEK 2 Compact from bio Mrieux company.Results The positive rate of pathogens was 11.76% from 1121 cerebrospinal fluild specimens.There were 132 strains of pathogens which included 80 Gram negative bacteria and 52 Gram positives bacteria.The most frequently isolated pathogen was Acinetobacter baumannii （34.09%）,followed by coagulasen negative staphylococcus （ 34.09% ） and enterobacter cloacae （ 13.64% ）.Gram negative bacteria was sensitive to cefoperazone/sulbactam,amikacin and tigecycline.Gram positives bacteria was sensitive to vancomycin and minocycline.Conclusions Pathogens from cerebrospinal fluid specimens is mainly Gram negative bacteria.The drug resistance of bacteria is very serious,so clinical doctors should use antibiotics accurately in order to slow down the increasement in strong resistant bacteria.