1012份脑脊液标本的病原菌及耐药性分析

目的:了解我院进行脑脊液细菌培养的患者的结果和科室分布及耐药情况,为临床科室的脑脊液培养提供建议和抗菌药物的使用提供依据和参考。方法:收集2009-10-2013-05的1 012份标本,采用脑脊液的普通三区划线培养对进行细菌的菌种进行鉴定及药物的敏感性进行分析。结果:从1 012份脑脊液标本中分离出105株阳性菌株,总的阳性率10.4%,其中真菌菌株5株(4.8%),革兰阴性的菌株79株(75.2%),革兰阳性的菌株21株(20.0%);排名前5位的病原菌依次为假单胞菌属42株(40.0%),鲍曼不动菌属18株(17.1%),溶血葡萄球菌株11株(10.5%),大肠埃希菌株9株(8.6%),阴沟肠杆菌株7株(6.7%);革兰阴性菌对哌拉西林/他唑巴坦的敏感性最好,敏感率为77.2%,革兰阳性菌对万古霉素敏感性最高为95.2%。结论:我院从脑脊液标本中检出的病原菌以革兰阴性菌为主,检出率最高的为假单胞菌属和不动杆菌属,本次研究对中枢神经系统感染的经验用药提供建议和参考。

Pathogens and distribution of department and their resistance to antibiotics from 1 012 cerebrospinal fluid specimens

Objective：To analyze the pathogenic results and drug resistance of bacteria isolated from cerebrospinal fluid specimens from Oct 2009 to May 2013, so as to provide evidence for clinical pathogenic analysis and selection of antibiotic. Method： The bacteria identification and the antimicrobial susceptibility were assayed. Result： The positive rate of pathogens was 10.4%from 1012 cerebrospinal fluid specimens. There were 105 strains of pathogens which included 21 Gram-positives, 79 Gram-negatives and 5 fungi. The most frequently isolated pathogen was Pseudomonas 42 （40 % ） followed by Bowman Fixed Bacteria Genera 18 （ 17.1% ）, Staphylococcus haemolyticus 11 （10.5 % ）and Escherichia coli 9 （8.6 % ）. The most active drugs against Gram-positive cocci and Gram-negative bacilli were vancomycin（95.2 % ） and piperaeillin/tazobaetam（77.2 % ）. Conclusion： The prevailing pathogens in cere brospinal fluid were Gram-negative bacilli. Data collected in present study provided valuable information for prophylactic and empirical antibiotic use in intracranial infection.