2009-2012年我院颅内感染常见致病菌及抗菌药物应用评价

Distribution and antibiotic resistance of bacteria isolated from cerebral spinal fluid and evaluation of antibiotics use

目的:了解我院颅内感染常见的病原菌、耐药状况及抗菌药物使用的合理性,为抗菌药物的合理应用提供参考。方法:收集我院2009年6月1日-2012年4月1日期间所有脑脊液培养阳性患者的病例,对病原菌的耐药性和抗菌药物使用情况进行统计分析。结果:脑脊液培养结果中,革兰阳性菌株占大多数(86.4%),特别是凝固酶阴性葡萄球菌,其次为金黄色葡萄球菌;只检出3种阴性菌共12株,检出的革兰阴性菌中,假单胞菌占阴性菌总数约60%;使用频率最高的抗菌药物为头孢曲松、万古霉素和头孢他啶;DUI普遍较高,大部分超过了1.2。不合理用药分别表现在品种选择、给药途径、单次给药剂量、给药间隔和配伍方面。结论:脑脊液分离菌株大部分为革兰氏阳性菌,菌株耐药率较高,抗感染药物使用有不合理之处。

Objective： To investigate the distribution and antibiotic resistance of pathogens isolated from the cerebral spinal fluid of patients with intracranial infection, and evaluate the rationality of the antibiotics use. Methods： Information on the bacterial isolates from cerebral spinal fluid specimens in Tianjin First Central Hospital was collected from June 1,2009 to April 1, 2012. The distribution, antibiotic resistance and use of antibiotics were analyzed, retropectively. Results： Of 88 isolates, Gram positive bacilli accounted for the most common pathogenic bacteria （86.4%） , among which coagulase negative staphylococci had the highest percentage followed by staphylo- coccus aureus; only 12 stains of Gram negative bacilli were cultured, among which 60% was pseudomnonas; the most frequently used antibiotics were cefriaxone, vancomycin, and ceftazidime in sequence. For most antibiotics, the DUIs were greater than 1.2. Irrational medication existed in the respects of antibiotics selection, administration route, dosage, dosing interval, and compatibility. Conclusions： The prevalent pathogens isolated from cerebral spinal fluid are Gram positive bactilli. There existed irrational antibiotics use in clinic.