颅内感染患者临床特征及脑脊液病原菌分析

Analysis of Clinical Features and Bacterial Pathogen Isolated from Cerebrospinal Fluid of Patients with Intracranial Infections

目的:探讨颅内感染患者临床特征变化及脑脊液病原菌情况,为临床颅内感染预防及合理用药提供参考。方法:分析脑外伤和非脑外伤组患者临床特征变化、病原菌分布及耐药性。结果:非脑外伤组患者较脑外伤组更易发生头痛、恶心、呕吐、脑水肿或脑积水。脑外伤组革兰阳性菌显著高于非脑外伤组。对于主要病原菌凝固酶阴性葡萄球菌,脑外伤组患者仅阿米卡星和替考拉宁耐药率低于非脑外伤组,其余耐药率均高于非脑外伤组。结论:不同致病因素引起的颅内感染患者临床表现、病原菌构成比及耐药性存在差异,临床上应结合具体病情及脑脊液病原菌结果,合理选择用药。

Objective： To explore the change of clinical features and the distribution and drug resistance of pathogens i- solated from cerebral spinal fluid of patients with intracranial infection,as to provide guidance for clinical prevention of intracranial infection and the resonable use of antibiotics. Methods： The clinical feature, distribution and drug resistance of the pathogens were analyzed between brain injury group and non-brain injury group. Results： It is easier to occur a headache, nausea, bomiting, brain edema or hydrocephalus in non-brain injury group than that in brain injury group. The isolation rate of the gram-positive bacteria was significantly higher in brain injury group than in non-brain injury group. For CoNS,only the resistant rate of amikacin and teicoplanin is lower in brain injury group than the non-brain injury group, and the rest of the resistance were higher. Conclusion： The clinical features, the distribution and drug resistance of pathogens varies in patients with intracranial infection induced by different factors. It is necessary to reasonably use antibiotics and clinical prevention of intracranial infection according to the specific condition and the result of cerebro- spinal fluid culture.