2300份成年人脑脊液培养及菌株耐药分析

目的 总结我院2002年1月至2005年6月送检的2300份成年人脑脊液的培养及药敏情况，供临床诊断和治疗参考。方法 采用美国DADE公司的Microscan Walkaway40全自动细菌鉴定及药敏分析系统进行细菌鉴定及药敏测定。结果 在2300份脑脊液标本中，检出阳性数180份（7．83％），其中细菌144株（革兰阳性菌98株，革兰阴性菌46株），真菌26株，结核分枝杆菌10株。链球菌和肠球菌对青霉素敏感，万古霉素对革兰阳性球菌均有较高的抗菌活性；革兰阴性菌对常用药物头孢噻肟和头孢曲松的敏感性较差，碳青霉烯类、氨曲南对革兰阴性菌有较好的抗菌活性；部分脑膜炎由结核杆菌及真菌所致。结论 本组脑膜炎以院内感染为主，提示临床医生应根据脑膜炎患者的特点，个体化用药，合理使用抗生素。

Analyses on the pathogens and their resistance to antibiotics from 2300 cerebrospinal fluild specimens of adults

Objective To analyze the pathogenic results and drug resistance of bacteria isolated from 2300 cerebrospinal fluild specimens of adults from 2002 to 2005 so as to provide evidence for clinical diagnosis and therapy of meningitis.Methods The bacteria identification and the antimicrobial susceptibility were assayed by automatic bacteria culture device Microscan Walkaway 40 from DADE Co.Results The positive rate of pathogens was 7.83%(180/2300)from 2300 cerebrospinal fluild specimens.There were 144 strains of bacteria which include 98 Gram positive bacteria and 46 Gram negative bacteria,26 fungi,and 10 Mycobacterium tuberculosis.Streptococcus spp.and Enterococcus spp.were sensitive to penicillin,all the Gram positive cocci were sensitive to vancomycin;the Gram negative bacteria were resistant to routine antibiotics such as cefotaxime and ceftriaxone,while they have high percentage of susceptibility to aztreonam and carbapenems and some cases were infected with Mycobacterium tuberculosis and fungi.Conclusion It suggests that clinicians should pay more attention to personalized therapy based on the characteristic of meningitis so as to attain rational use of antibiotics.