颅内感染患者脑脊液病原菌培养结果及常用抗菌药物的耐药性研究

Culture results of pathogenic bacteria in cerebrospinal fluid of patients with intracranial infection and drug resistance to common antibiotics

目的分析颅内感染患者脑脊液病原菌培养结果及常用抗菌药物的耐药性。方法抽取2019年10月至2020年11月郑州市中医院收治的颅内感染患者79例,采集其脑脊液标本进行培养,行病原菌培养和药敏试验,进行病原菌特点及耐药检测分析。结果79份颅内感染患者脑脊液标本中,共分离出87株病原菌;其中革兰阴性菌株51株,占比58.62%,以革兰阴性短杆菌(14.94%,13/87)、绿脓杆菌(22.99%,20/87)为主;革兰阳性菌株30株,占比34.48%,以凝固酶阴性葡萄球菌(16.09%,14/87)、金黄色葡萄球菌(8.05%,7/87)为主。绿脓杆菌对菌特灵、氨噻三嗪耐药率较高,对丁胺卡那霉素、嗜气芽孢菌素无耐药性;革兰阴性短杆菌对西力欣、氨噻三嗪耐药率较高,对嗜气芽孢菌素、麦罗派南、亚胺硫霉素无耐药性。凝固酶阴性葡萄球菌、金黄色葡萄球菌对氨噻三嗪、头孢唑林及西力欣耐药率较高。结论颅内感染患者脑脊液病原菌种类复杂,主要以革兰阴性菌为主,其次为革兰阳性菌株,依据主要致病菌对常用抗菌药物的耐药率,合理选择抗菌药物,可提高抗感染效果。

Objective To analyze the culture results of pathogenic bacteria in cerebrospinal fluid of patients with intracranial infection and the drug resistance to common antibiotics.Methods A total of 79 patients with intracranial infection treated in Zhengzhou Hospital of Traditional Chinese Medicine from October 2019 to November 2020 were selected.Cerebrospinal fluid samples were collected from them for culture.Pathogen culture and drug sensitivity test were performed to analyze and pathogen characteristics and drug resistance.Results A total of 87 strains of pathogenic bacteria were isolated from 79 cerebrospinal fluid samples of patients with intracranial infection.Gram-negative strains accounted for 58.62%(51 strains),of which were mainly Gram-negative bacillus brevis(14.94%,13/87)and Pseudomonas aeruginosa(22.99%,20/87).There were 30 gram-positive strains in the 79 cerebrospinal fluid samples,accounting for 34.48%,and coagulase negative staphylococcus(16.09%,14/87)and Staphylococcus aureus(8.05%,7/87)were the main strains.Pseudomonas aeruginosa had higher drug resistance rate to mycetoline and amthiazine,but had no drug resistance to amikacin and aerophenin.The resistance rate of short Gram-negative bacilli to cilicine and amthiazine was high,and had no resistance to aerophosphorin,meropepinam and imithiomycin.Coagulase negative staphylococcus and Staphylococcus aureus had higher drug resistance rates to amthiazine,cefazolin and cilixin.Conclusions The types of pathogenic bacteria in cerebrospinal fluid of patients with intracranial infection are complex,mainly gram-negative bacteria,followed by gram-positive strains.According to the resistance rate of main pathogenic bacteria to commonly used antibacterial drugs,rational selection of antibacterial drugs can improve the anti-infection effect.