颅内感染病原菌的构成及耐药性分析

目的 分析颅内感染的致病菌分布及耐药性，为临床治疗提供参考。方法 对2016年1月至2018年4月收集的13 712例脑脊液样本培养结果进行回顾性分析。结果 共有877例颅内感染，感染率为6.40%。革兰阳性菌占81.64%，其中耐甲氧西林凝固酶阴性葡萄球菌占46.86%，甲氧西林敏感凝固酶阴性葡萄球菌占18.70%，对替加环素、万古霉素及利奈唑胺敏感；革兰阴性菌占18.36%，其中鲍曼不动杆菌表现出广泛耐药性，肺炎克雷伯菌对碳青霉烯类及酶抑制剂类药物敏感。结论 颅内感染以革兰阳性菌为主，对替加环素、万古霉素及利奈唑胺敏感；革兰阴性菌中鲍曼不动杆菌多数耐药。

Composition of pathogenic bacteria of nosocomial intracranial infection and analysis of their resistance to drugs

Objective To analyze the distribution of pathogenic bacteria of nosocomial intracranial infection and their resistance to drugs in order to provide the basis for clinical choice of the appropriate antibiotics. Methods The data of 877 strains of intracranial infection pathogenic bacteria who were positive on the cerebrospinal fluid culture and their resistance to drugs from January, 2016 to April, 2018 were investigated retrospectively. Results Of these 877 strains of the bacteria, 716 (81.46%) including methicillin-resistant coagulase-negative staphylococci (46.86%), methicillin-sensitive coagulase-negative staphylococci (18.70%) and so on, were Gram-positive bacteria and 161 (18.36%) including Acinetobacter Bauman, Klebsiella pneumonia and so on, were Gram-negative. The Gram-positive bacteria were sensitive to tigecycline, vancomycin and linezolid. Acinetobacter Bauman had widespread drug resistance; Klebsiella pneumoniae was sensitive to carbapenem and enzyme inhibitors. Conclusion Understanding of distribution and drug resistance of pathogenic bacteria is very helpful to the clinical rational selection of antibiotics in early stage of intracranial infection, improving the prognosis of patients, and decrease in the production of drug-resistant strains.