临床外科杂志 ›› 2021, Vol. 29 ›› Issue (2): 132-135.doi: 10.3969/j.issn.1005-6483.2021.02.010

• • 上一篇    下一篇

神经外科术后颅内感染的菌种分布及其耐药性分析

  

  1. 三峡大学人民医院/宜昌市第一人民医院神经外科
  • 出版日期:2021-02-20 发布日期:2021-02-20

Bacteria  distribution and drug resistance analysis of postoperative intracranial infection

  • Online:2021-02-20 Published:2021-02-20

摘要: 目的:对我院神经外科术后颅内感染病人的病原菌及其耐药性进行统计分析,以了解颅内感染的菌种分布及药物耐受情况。方法:2013年1月~2018年12月我院收治的术后颅内感染病人156例,采集病人的脑脊液标本,对脑脊液培养检查及培养的病人的病原菌分布及耐药情况进行统计分析。结果:156例术后颅内感染病人中,共培养出病原菌147株;其中革兰阳性菌62株,占42.2%,主要菌株包括金黄色葡萄球菌、表皮葡萄球菌、凝固酶阴性葡萄球菌、肠球菌属;革兰阴性菌84株,占57.1%,主要菌株包括鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、阴沟肠杆菌,真菌1株(0.68%)。革兰阳性菌中耐药率较低的为哌拉西林/他唑巴坦、利奈唑胺,万古霉素、替加环素耐药率为0。革兰阴性菌中耐药率普遍较高,鲍曼不动杆菌对绝大部分抗生素均耐药,仅对多黏菌素耐药率为0。结论:术后颅内感染病人革兰阴性菌占比较革兰阳性菌更大,且革兰阴性菌中耐药率普遍较高。目前针对革兰阳性菌使用哌拉西林/他唑巴坦、利奈唑胺或者万古霉素仍是有效的。革兰阴性菌对绝大多数抗生素耐药,多黏菌素对其仍有较高的敏感性。

关键词: 术后颅内感染, 菌种分布, 耐药性

Abstract: Objective:The pathogenic bacteria and drug resistance of postoperative intracranial infection patients in the department of neurosurgery of our hospital were statistically analyzed,in order to understand the distribution of intracranial infection strains and drug tolerance.Method:A total of 156 patients with postoperative intracranial infection were selected from the Department of neurosurgery in our hospital from 2013.1.1 to 2018.12.31,and the samples of cerebrospinal fluid were collected from the patients.The distribution and drug resistance of the patients in the cerebrospinal fluid culture examination and culture were statistically analyzed.Result:A total of 147 pathogens were cultured in 156 postoperative intracranial infection;62 strains of grampositive bacteria(42.2%),the main strains include staphylococcus aureus,staphylococcus epidermidis,coagulasenegative staphylococcus;84 strains of gramnegative bacteria(57.1%),the main strains include acinetobacter baumannii,pseudomonas aeruginosa,klebsiella pneumonia,enterobacter cloacae;1 strain of fungi(0.68%).The lower resistance rates among grampositive bacteria were piperacillin/tazobactam,linezolid,The drug resistance rate of vancomycin and tigecycline was 0.The rate of drug resistance is generally high in gramnegative,acinetobacter baumannii is resistant to most antibiotics,the resistance rate to polymyxin was 0.〖WTHZ〗Conclusion:Gramnegative bacteria of postoperative intracranial infection accounted for a larger proportion of grampositive bacteria,and the drug resistance rate in gramnegative bacteria is generally higher.Currently,piperacillin/tazobactam,linezolid or vancomycin is still effective against grampositive bacteria.Gramnegative bacteria are resistant to most antibiotics.polymyxin are still highly sensitive to it.

Key words: postoperative intracranial infection, bacteris distribution, drug resistance

[1] 刘征, 杨为民. 泌尿系感染致病菌耐药的危险因素分析[J]. 临床外科杂志, 2019, 27(2): 107-108.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 胡伟鹏;陈龙奇. 食管癌切除食管胃胸内吻合与颈部吻合的现状与探索[J]. 临床外科杂志, 2016, 24(7): 550 .
[2] 汪进益 洪暄 柴正军等. 机器人臂辅助3D-高清全胸腔镜用于直径>5cm肺癌的体会[J]. 临床外科杂志, 2016, 24(9): 724 .
[3] 霍明科;韩广森;赵玉洲 . 开腹减压后择期行腹膜后巨大脂肪肉瘤切除一例[J]. 临床外科杂志, 2017, 25(3): 240 .
[4] 梁寒. 日本第15版“胃癌处理规约”及第5版“胃癌治疗指南”外科部分更新解读[J]. 临床外科杂志, 2018, 26(1): 22 .
[5] 于琦, 王钢乐. 非哺乳期乳腺炎的临床诊治研究[J]. 临床外科杂志, 2019, 27(3): 201 -203 .
[6] 陈志超, 王杰芳. 乳腺癌手术切口皮肤缝合器与丝线间断缝合的对比分析[J]. 临床外科杂志, 2019, 27(4): 289 -290 .
[7] 黄伟, 罗云蔓, 程中华. 经椎板间隙小开窗与经椎弓根椎体内植骨治疗胸腰椎爆裂性骨折的疗效比较[J]. 临床外科杂志, 2019, 27(4): 320 -323 .
[8] 徐亮, 刘凤英, 丁倩. Caprini评分、D-二聚体、纤维蛋白原水平在骨折后下肢深静脉血栓病人中的变化及其临床意义[J]. 临床外科杂志, 2019, 27(4): 328 -330 .
[9] 李子禹, 薛侃. 胃癌外科诊疗有感[J]. 临床外科杂志, 2019, 27(5): 361 -362 .
[10] 周东, 何艳平, 李恒平, 黄卫东. 不同腹腔镜胃癌根治术对原发性胃癌病人胃肠动力、炎性应激及预后的影响分析[J]. 临床外科杂志, 2019, 27(5): 436 -438 .