神经外科术后颅内感染患者脑脊液培养结果分析

Cerebrospinal fluid culture for patients with intracranial infections in neurosurgery department

目的分析神经外科术后颅内感染患者脑脊液的病原菌特征,探讨感染的相关因素。方法回顾性分析482例神经外科术后患者的临床资料、感染率和感染相关因素及病原菌特征。结果 482份脑脊液标本,培养阳性71例,阳性率为14.72%;共分离出病原菌83株,革兰阳性菌44株,占53.01%,革兰阴性菌36株,占43.37%,真菌3株,占3.61%;分布最多的3种病原菌为凝固酶阴性葡萄球菌、鲍氏不动杆菌和金黄色葡萄球菌,分别占31.33%、16.87%和14.46%;单因素χ2检验显示,颅内感染与糖尿病、开放性颅脑损伤、脑脊液漏和脑室外引流有关(P<0.05)。结论凝固酶阴性葡萄球菌是神经外科术后颅内感染的主要致病菌,应针对相关易感因素,加强微生物监测、合理有效预防颅内感染。

OBJECTIVE To analyze the features of distribution of pathogens isolated from cerebrospinal fluid in neurosurgery patients undergoing surgery,and to explore the factors related to intracranial infections.METHODS The clinical data of 482 patients undergoing surgery in neurosurgery department were studied retrospectively.The infection rate,factors related to infections,and pathogenic distribution were evaluated.RESULTS Totally 71 out of 482 cerebrospinal fluid specimens were cultured positive with the positive rate of 14.72%.A total of 83 strains of pathogens were isolated,including 44（53.01%） strains of gram-positive bacteria,36（43.37%） strains of gram-negative bacteria,and 3（3.61%） strains of fungi.The coagulase-negative Staphylococci,Acinetobacter baumannii and Staphylococcus aureus ranked the top three of the pathogens,accounting for 31.33%,16.87%,and 14.46%,respectively.The univariate chi-square test showed that the intracranial infections were related to the diabetes mellitus,open craniocerebral injury,cerebrospinal fluid leakage,and external ventricle drainage（P0.05）.CONCLUSION Coagulase-negative Staphylococci are the predominant species of pathogens causing intracranial infections in the neurosurgery department.According to the related predisposing factors,it is necessary to strengthen the microbial monitoring so as to effectively prevent the intracranial infections.