神经外科患者脑脊液感染的细菌流行病学分布和耐药性监测

Distribution and antibiotic resistance surveillance of bacteria isolated from infected cerebral spinal fluid in neurosurgical patients

目的 了解4年来我院神经外科住院患者的脑脊液致病菌流行病学及耐药状况,为以后合理应用临床抗菌药物及提高经验性用药的准确性提供依据.方法 从我院神经外科2009 年3月-2013 年3 月的住院患者中,抽取脑脊液标本进行检测,鉴定并统计感染菌分布及抗菌药物敏感率.结果 分离到致病菌334株,其中革兰阳性球菌201株,占60.2%;革兰阴性杆菌133株,占39.8%;鉴定其最常见的致病菌为表皮葡萄球菌（46.7%）、鲍曼不动杆菌（13.5%）、金黄色葡萄球菌（6.9%）和铜绿假单胞菌（6.9%）这四类;对革兰阳性菌总体敏感率最高的为万古霉素（97.0%）,对革兰阴性菌的总体敏感率最高的为亚胺培南（88.7%）.结论我院4年来神经外科患者脑脊液感染以革兰阳性菌多见,本研究结果为我院神经外科颅内感染的预防和经验性抗菌药物治疗提供了基本数据依据.

Objective To understand the epidemiological distribution and antibiotic resistance surveillance of bacteria isolated from infected cerebral spinal fluid in neurosurgical patients in 4 years and provide evidence for promoting the rational administration of antibacterial agents. Methods The samples of intracranial infectious patients from March 2009 to March 2013 were collected and identified. The distribution of infection bacterial and antimicrobial drug sensitive rate were calculated. Results The total of 334 pathogenic strains were isolated from cerebrospinal fluid specimens, among them gram-positive bacteria were 201 strains （60.2%）; Gram-negative bacilli 133 strains（39.8%）. The most frequently isolated pathogen was staphylococci （46.7%） followed by Acinetobacter baumannii （13.5%）,Staphylococcus aureus （6.9%） and Pseudomonas aeruginosa （6.9%）. 97% of Gram-positive bacteria was susceptible to Vancomycin, while the rate of sensitivity of imipenem for Gram-negative bacteria was 88.7%. Conclusion Gram-positive bacteria are com- mon in heurosurgery patients with intracranial infection in 4 years,This study will provide the basic data basis on the hospital neurosurgery empirical anti ni crobial treatment of intractanial infection prvevntion.