我院2010年1月-2011年7月神经外科脑脊液病原菌种类及耐药性分析

目的:了解我院神经外科脑脊液病原菌的分布及耐药情况,以期为临床合理应用抗菌药物提供参考。方法:对我院2010年1月-2011年7月神经外科送微生物室检测的435份脑脊液标本的细菌培养及药敏测定结果进行回顾性分析。结果:检出病原菌阳性标本88份(20.2%),其中革兰阳性(G+)球菌45株,革兰阴性(G-)杆菌40株,真菌3株。G+球菌对替考拉林、万古霉素和利奈唑胺敏感率达100%,未检出耐药菌株。G-杆菌中的肺炎克雷伯菌对亚胺培南、美罗培南敏感率达100%,对头孢哌酮/舒巴坦钠、哌拉西林/他唑巴坦的耐药率较低(均<45%),而对其他青霉素类、头孢菌素类抗菌药物表现出较高的耐药性(>80%);不动杆菌属对头孢哌酮/舒巴坦钠的耐药率较低(24.1%),而对其他抗菌药物呈多重耐药性。结论:神经外科颅内感染患者G+球菌以葡萄球菌多见;G-杆菌以鲍曼/醋酸钙不动杆菌多见。临床应根据药敏试验结果合理应用抗菌药物,以减少病原菌的多重耐药性。

Analysis of Pathogen Species in Cerebrospinal Fluid and Their Drug Resistance in Neurosurgery Department of Our Hospital during Jan.2010-Jul.2011

OBJECTIVE:To investigate the distribution and drug resistance of pathogenic bacteria in cerebrospinal fluid obtained from neurosurgery department of our hospital in order to provide reference for rational use of antibiotics in the clinic.METHODS:Bacterial culture and drug sensitivity test of 435 cerebrospinal fluid samples from neurosurgery department to microbiology laboratory were analyzed retrospectively.RESULTS:88 samples (20.2%) showed positive in cultures,among which there were 45 strains of Gram-positive (G+),40 strains of Gram-negative(G-) and 3 strains of fungus.The percentage of sensitivity of the G+ strains to teicoplanin,vancomycin and linezolid was all 100%,indicating that no G+ strain was resistant to these antibiotics.The sensitivity rate of Klebsiella pneumonia,a G-strain,to imipenem and meropenem was 100%,while sensitivity to cefoperazone sodium and sulbactam,piperacillin and tazobactam was less than 45%;however,it showed higher resistance to penicillins,cephalosporins(>80%).The resistance rate of acinetobacter spp to cefoperazone sodium and sulbactam was relatively low (24.1%) while they showed multiple resistance to others antibacterials.CONCLUSION:Intracranial infection is mostly caused by G+ strains like staphylococcus,or G-strains like Acinetobacter baumannii/Acinetobacter calcoaceticus.We should use the antibiotics rationally according to the sensitivity test in order to reduce the multiple resistance to antibiotic.