338份脑脊液细菌培养及药物敏感性情况分析

Bacterial culture and drug resistance from 338 cerebrospinal fluid specimens

目的：调查常规送检的脑脊液培养结果及药物敏感性（药敏）状况，以期对临床诊断和治疗用药提供参考。方法采用法国梅里埃公司 VITEK 2 Compact 型全自动微生物鉴定仪进行细菌鉴定及药敏实验。结果338份脑脊液标本中，检出病原菌60株，阳性率17.8%，其中革兰阳性菌39株，革兰阴性菌20株，真菌1株；革兰阳性菌对万古霉素较为敏感，对青霉素、红霉素、苯唑西林、氨苄西林和头孢唑啉耐药率较高，革兰阴性菌对碳青霉烯类和阿米卡星敏感，鲍曼不动杆菌对哌拉西林、亚胺培南、左氧氟沙星、庆大霉素和头孢菌素类的耐药率高达70.0%-100.0%。结论脑脊液标本检出的病原菌以革兰阳性菌多见，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（CSF）specimens for clinical diagnosis and treatment reference.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 1 7.8% from 338 cerebrospinal fluid specimens.There were 60 strains of pathogens which included 39 gram-positives,20 gram-negatives and 1 fungi.Gram-positive bacteria were more sensitive to vancomycin,but were resistant to penicillin,erythromycin,oxacillin,ampicillin and cefazolin.Gram negative bacteria were more sensitive to carbapenems and amikacin,Acinetobacter baumannii showed resistance rates to piperacillin,imipenem,levofloxacin,gentamicin and cephalosporins as high as 70.0% to 100.0%.Conclusion Pathogens from CSF specimens are mainly gram positive bacteria,the drug resistance of bacteria is very serious,so clinical doctors should use antibiotics accurately in order to slow down the increase in strong resistant bacteria.