颅脑手术后医院内肺炎病原菌及耐药性分析

目的: 了解颅脑手术后院内肺炎的发病率、致病菌及耐药率以指导临床用药。方法: 统计分析2002年全年我院神经外科颅脑手术后病人肺炎发生率，痰培养阳性细菌及药敏试验结果。结果: 颅脑手术后医院内肺炎的发病率为6.2%。病原菌居前5位的是：铜绿假单胞菌、不动杆菌、肠杆菌属、克雷伯菌属、表皮葡萄球菌。对氨苄西林、头孢呋肟耐药率均大于83%；舒普深、亚胺硫酶素对革兰阴性(G-)杆菌的耐药率最低。革兰阳性(G+)球菌对万古霉素、氨苄西林/舒巴坦和利福平耐药性较低。结论: 颅脑手术后下呼吸道感染发病率高，以G-杆菌为主，其耐药现象严重。

Pathogens and drug resistance of nosocomial pneumonia after intracranial surgery

Objective To determine the antimicrobial resistance and bacterial distribution of nosocomial pneumonia in neurosurgical patients.Methods We analyzed and counted the result of sputum culture, drug sensibilities test, and the rate of nosocomial pneumonia after intracranial surgery of all the patients in the Department of in Neurosurgery our hospital in 2002.Results The rate of nosocomial pneumonia after intracranial surgery was 6.2 %. The first 5 strains were pseudomonas aeruginosa,acinetobacter,enterobacteriaceae,klebsiella,and staphylococcus epidermidis.Statistics of drug sensibility test suggested:the rate of ampicillin and cefuroxime resistance was over 83%.Gram negative bacterium was the first sensitive to sulperazon and imipenem.Gram positive bacterium was the first sensitive to vancomycin, ampicillin/sulbactam and rifampicin. Conclusion The rate of neurosurgical infection was high.The most common pathogens were gram negative bacteria.Drug resistance was serious.