神经外科患者脑脊液细菌流行病学和耐药性10年监测

目的 监测神经外科患者脑脊液致病菌流行病学分布及耐药状况.方法 收集北京天坛医院神经外科1997年8月至2006年9月,送检脑脊液标本中分离的致病菌及药敏鉴定结果,统计致病菌分布和抗菌药物敏感率.结果 分离到致病菌970株,其中革兰阳性球菌720株;革兰阴性杆菌250株.排名前6位的致病菌分别为:表皮葡萄球菌(25.4%),金黄色葡萄球菌(9.4%),不动杆菌(6.9%),肠杆菌属(5.0%),铜绿假单胞菌(2.8%),肠球菌属(2.8%).对革兰阴性菌的平均敏感率亚胺培南为94%,阿米卡星为75%,头孢吡肟为59%,头孢他啶为54%.对革兰阳性球菌(葡萄球菌属,肠球菌属)平均敏感率万古霉素为100%,利福平为78.2%,复方磺胺甲嗯唑为65.6%,苯唑西林为16.7%.结论 神经外科患者颅内感染以革兰阳性球菌多见,尤其是表皮葡萄球菌和金黄色葡萄球菌.本组结果可为神经外科手术部位感染的预防和经验性抗菌药物治疗提供基本数据资料.

Distribution and antimicrobial resistance of bacteria isolated from cerebral spinal fluid in neurosurgical patients:a ten years surveillance

Objective To determine the distribution and antibiotic resistance of bacteria isolated from cerebral spinal fluid in neurosurgical patients.Methods Bacterial isolated from cerebral spinal fluid specimens of patients admitted to department of neurosurgery in Beijing Tiantan Hospital were collected during Aug.1997 to Sep.2006.Distribution and antibiotic resistance of pathogens were analyzed retrospectively.Results Of 970 isolates,Gram positive cocci and Gram negative bacilli accounted for 74.2%(720 isolates)and 25.8%(250 isolates),respectively.The most frequently isolated pathogen was Staphylococcus epidermidis(25.4%)followed by Staphylococcus aureus(9.4%),Acinetobacter spp(6.9%),Enterobacter spp(5.0%)Pseudomonas aeruginosa(2.8%),and enterococc(2.8%).The most active compounds against Gram-negative bacilli were imipenem(94% susceptibility),amikacin(75%),cefepime(59%)and ceftazidime(54% susceptibility).Average susceptibility of Vanconmycin and rifampin to Gram positive cocci was 100% and 78.2%,respectively.The average drug suspectility of Oxacillin and sulfarmethoxazole/trimethoprim aganist Staphylococcus was 16.7% and 65.6%,respectively.Conclusions The prevailing pathogens in post-operative intracranial infection are Gram positive cocci,especially Staphylococcus epidermidis and Staphylococcus aureu.Data collected in present study provide valuable information for prophylactic and empirical antibiotic use in post-operative intracranial infection.