中枢神经系统感染病原菌临床分析

Clinical analysis of pathogens causing central nervous system infections

目的分析中枢神经系统感染的临床特点和病原学特征,为提高疾病治疗效果提供依据。方法回顾性分析医院2010年7月-2012年7月收治的中枢神经系统感染患者的临床资料,总结分析中枢神经系统感染患者的临床表现、感染菌病原学特点等。结果入选的199例病例中发生呕吐21例、头痛179例、脑膜刺激征166例,发生率分别为10.5%、89.9%、83.4%;实验室检查中,脑脊液浑浊161例,脑脊液澄清38例,分别占80.9%、19.1%;共培养出227株病原菌,其中革兰阳性菌98株占43.2%,革兰阴性菌121株占53.3%;其他8株占3.5%;表皮葡萄球菌和溶血葡萄球菌对万古霉素、利奈唑胺、替考拉宁和磷霉素等抗菌药物敏感。结论中枢神经系统感染的主要病原菌为革兰阳性菌和革兰阴性菌,应根据药敏试验结果,合理使用抗菌药物,提高临床治疗效果,缩短治疗时间。

OBJECTIVE To analyze the clinical characteristics of the central nervous system infections and the etiological characteristics. METHODS A retrospective analysis was conducted to review the clinical data of patients with central nervous system infections who were treated in the hospital from Jul 2010 to Jul 2012, the clinical man- ifestations and the etiological characteristics of the pathogens were analyzed. RESULTS Of totally 199 cases of patients enrolled in the study, there were 21（10.5~） cases with emesia, 179 （89.9%） cases with cephalea, and 166 （83.4M） cases with meningismus. The laboratory examination showed that there were 161 （80. 9%） cases with turbid cerebrospinal fluid and 38 （19.1~） cases with clear cerebrospinal fluid. A total of 227 strains of pathogens were isolated, among which there were 98 （43.2o//00） strains of gram-positive bacteria, 121（53.3~） strains of gram-negative bacteria ,and 8 （3.50/~） strains of others. The Staphylococcus epiderrnidis and Staphy- lococcus haemolyticus strains were susceptible to vancomycin, linezolid, teicoplanin, and fosfomycin. CONCLUSION The gram-positive bacteria and gram-negative bacteria are the main pathogens causing the central nervous system infections. It is necessary to reasonably use antibiotics based on the result of drug susceptibility testing so as to improve the therapeutic effect and shorten the treatment time.