神经内外科脑脊液标本细菌流行病学分布和耐药性分析  

Distribution and antibiotic resistance of bacteria isolated from cerebrospinal fluid of patients in neurology and neurosurgery departments

作　　者：荆楠[1] 唐明忠[1] 刘志忠[1] 康熙雄[1] 

机构地区：[1]首都医科大学附属北京天坛医院检验科,北京100050

出　　处：《首都医科大学学报》2012年第2期143-147,共5页Journal of Capital Medical University

基　　金：国家高技术研究发展计划(863计划)(2006AA020706-03)~~

摘　　要：目的监测并比较神经内外科脑脊液标本培养阳性的细菌流行病学分布及耐药状况,以期对临床抗菌药物治疗提供依据。方法对送检脑脊液标本进行细菌培养、鉴定及抗菌药物敏感(简称药敏)试验,比较病原菌分布和药敏结果。结果 1)细菌构成比比较:革兰阳性菌(G+菌)在神经外科中的比例(67.2%)高于神经内科(56.1%),铜绿假单胞菌在神经内科革兰阴性菌(G-菌)中所占比例(20.4%)高于神经外科(6.7%),鲍曼不动杆菌在神经外科G-菌中的比例(37.8%)高于神经内科(22.4%)。2)细菌药敏:G+菌对万古霉素、利奈唑胺敏感率高,G-菌对亚胺培南、阿米卡星敏感。神经外科铜绿假单胞菌比神经内科对环丙沙星的敏感率更高。神经外科表皮葡萄球菌对利福平更敏感。结论神经内外科中枢神经系统感染多为院内感染,以革兰阳性菌为主。监测并比较颅内感染病原菌分布及药敏情况,可为神经内外科颅内感染的预防和经验性抗菌药物治疗提供可靠数据资料。Objective To determine the distribution and antibiotic resistance of bacteria isolated from cerebrospinal fluid so as to provide evidence for clinical selection of antibiotics.Methods The bacterial identification and antibiotic resistance tests were performed for cerebrospinal fluid culture-positive specimens.Results 1） Comparison of bacteria constituent ratio： the ratio of Gram-positives was higher in Neurosurgery Department（67.2%） than Neurology Department（56.1%）.The ratio of Pseudomonas aeruginosa in Gram-negatives was higher in Neurology Department.The ratio of Acinetobacter baumanii was higher in Neurosurgery Department.2） Bacterial susceptibility： The Gram-positives were sensitive to vancomycin and Linezolid,while Gram-negatives were sensitive to imipenem and amikacin.Pseudomonas aeruginosa,isolated from Neurosurgery Department,had higher antimicrobial susceptibility to ciprofloxacin than those from Neurology Department.Staphylococcus epidermidis in Neurosurgery Department were more sensitive to Rifampicin.Conclusion Central nervous system infection was basically nosocomial infection and the prevailing pathogens were Gram-positives.The observation of bacterial distribution and antibiotic resistance will provide valuable information for prophylactic and empirical antibiotic use in intracranial infection.

关 键 词：脑脊液 细菌耐药性 颅内感染 

分 类 号：R446.5[医药卫生—诊断学]