中国临床药学杂志

目的分析我院近5年神经外科颅内感染患者的脑脊液病原菌分布特点及耐药变化,为神经外科合理选用抗菌药物治疗颅内感染提供依据。方法利用病历系统查询并收集到2011至2015年神经外科66例颅内感染患者的脑脊液培养病原菌种类、数量、对抗菌药物敏感性等数据,分析该5年内病原菌的流行特点和药敏情况。结果 2011至2015年从我院神经外科颅内感染患者的脑脊液中分离、培养出病原菌112株,其中革兰阳性菌占56.25%,革兰阴性菌占43.75%。最常见的病原菌分别是表皮葡萄球菌(27.68%)、金黄色葡萄球菌(23.21%)、鲍曼不动杆菌(16.07%)和肺炎克雷伯菌(10.71%)。分离的革兰阳性菌与阴性菌均呈不同程度的耐药;金黄色葡萄球菌耐药率高,仅对利奈唑胺、万古霉素敏感率为100.00%;鲍曼不动杆菌对碳青霉烯类抗菌药物的耐药率已高于30%;肺炎克雷伯菌对常用抗菌药物耐药率低。结论引起神经外科颅内感染的细菌耐药性越来越严重,必需严密监测细菌耐药,规范预防和治疗用药。

AIM To investigate and analyze the distribution characteristics of bacteria from cerebrospinal fluid of postoperative intracranial infection and antimicrobial resistance changes in recent 5 years in department of neurosurgery of our hospital,and to provide the basis for the rational use of antimicrobial drugs in department of neurosurgery. METHODS Types,quantity,antimicrobial drugs susceptibility results and medication data of cerebrospinal fluid culture pathogenic bacteria from patients with intracranial infection in department of neurosurgery were got by using HIS system and classifying pathogenic bacteria,the epidemic characteristics and drug sensitivity were analyzed from 2011 to 2015. RESULTS Totally 112 strains of pathogenic bacteria were isolated from the cerebrospinal fluid in the past 5 years,and including 63 gram-positive strains( 56. 25%),49 gram-negative strains( 43.75%). Most common isolates bacteria were Staphylococcus epidermidis( 27. 68%),Staphylococcus aureus( 23.21%),Acinetobacter baumannii( 16. 07%) and Klebsiella pneumoniae( 10. 71%). Isolated gram-positive bacteria and gram-negative bacteria were resistant to antibacterial agents in different degree. The sensitivity rate was 100.00% only in linezolid and vancomycin against Staphyococcus aureus. The resistant rates of carbapenems against Acinetobacter baumannii were higher than 30. 00%,the drug resistance rate of the Klebsiella pneumoniae strains to the common antimicrobial drugs were low. CONCLUSION Bacterial resistance of postoperative intracranial infection in department of neurosurgery is more and more serious. The bacterial resistance must be closely monitoring,and the prevention and treatment uses of drugs need to be standardized.