中枢神经系统感染患者常见病原菌分布及耐药性分析

Distribution and drug resistance of common pathogens in central nervous system infections

目的探讨中枢神经系统感染常见病原菌分布及对抗菌药物的敏感性分析,为合理选择抗菌药物治疗提供依据。方法选取2011年6月-2013年6月收治的中枢神经系统感染患者86例,对其进行脑脊液病原菌的培养、鉴定及药敏试验的检测;所有数据采用SPSS17.0进行统计分析。结果 86例患者脑脊液中分离出91株病原菌,其中革兰阳性菌62例占68.13%、革兰阴性菌27例占29.67%、真菌2例占2.20%,分布最多的病原菌主要有凝固酶阴性葡萄球菌52株占57.14%、金黄色葡萄球菌7株占7.69%、铜绿假单胞菌9株占9.89%、阴沟肠杆菌12例占13.19%;革兰阳性菌对万古霉素、喹奴普汀/达福普汀等耐药率较低,而对阿莫西林和青霉素耐药率较高,均>90.00%;革兰阴性菌对头孢他啶、头孢曲松的敏感性较差,其耐药率均达到100.00%,而对亚胺培南有较好的敏感性,敏感率为100.00%。结论中枢神经系统感染的病原菌种类较多,常见的主要为凝固酶阴性葡萄球菌,临床医师需要根据医院感染病原菌特点选择合适的抗菌药物进行治疗,提高治疗疗效。

OBJECTIVE To analyze distribution and drug resistance of common pathogens in central nervous system infection and provide a reference for rational selection of antibiotics. METHODS A total of 86 patients with central nervous system infection from Jun. 2011 to Jun. 2013 in our hospital were studied. Culture of pathogens in cere- brospinal fluid of patients, identification and susceptibility experiment were conducted. The SPSS software was used for statistical analysis. RESULTS A total of 91 pathogens from the cerebrospinal fluid of 86 patients were detected, including gram-positive bacteria in 62 cases, accounting for 68. 13%, and gram-negative bacteria in 27 cases （29.67%）, fungi in two cases （2. 20%）. The most widely distributed pathogens were eoagulase-negative Staphylococci of 52 strains, accounting for 57.14 %, Staphylococcus aureus of 7 strains （7.69%）, Pseudornonas aeruginosa of 9 strains （9.89%%）, Enterobacter cloacae in 12 cases （13. 19%）. It was found that gram-positive bacteria had a low resistance to vancomycin and quinupristin/dalfopristin, a high resistance to amoxicillin and peni- cillin, all above 90.00%. The susceptibility of gram-negative bacteria to commonly used antimicrobial drugs such as ceftazidime and ceftriaxone was poor, its resistance reached 100.00%, while the sensitivity to imipenem was good, reaching 100.00 %. CONCLUSION Pathogens of central nervous system infection are various, and eoagulase- negative Staphylococci is the main common pathogen. Clinicians should select the appropriate antibiotics for treat- ment based on the characteristics of pathogens in hospital so as to improve treatment efficacy.