长期留置脑室引流管患者颅内感染的调查  

Investigation of intracranial infections in patients with long-term ventricular drainage tube indwelling

作　　者：李作凌[1] 邢亚洲[1] 马春晓[1] 屈鸣麒[1] 杨春燕[1] 唐丽华[1] 丁艮晓[1] 王传玺[1] 

机构地区：[1]河南省人民医院神经外科,河南郑州450003

出　　处：《中华医院感染学杂志》2016年第6期1348-1350,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关基金资助项目(0424410154)

摘　　要：目的调查长期留置脑室引流管患者发生颅内感染的状况,为降低颅内感染的发生提供参考依据。方法回顾性分析2013年2月-2015年6月医院神经外科颅脑手术后进行引流的412例患者临床资料,研究置管部位和留置时间对长期留置脑室引流管患者发生颅内感染的影响,并分析发生颅内感染常见病原菌及耐药性,数据采用SPSS 19.0软件进行统计分析。结果置管部位为脑室的患者感染率为23.97%,高于其他部位,差异有统计学意义（P〈0.05）;留置时间1~2、3~4、≥5d的感染率分别为5.50%、26.03%、41.67%;颅内感染病原菌主要为金黄色葡萄球菌、铜绿假单胞菌、热带假丝酵母菌,分别占27.14%、21.43%、12.86%;金黄色葡萄球菌对氨曲南、青霉素耐药率较高≥50.00%,肺炎链球菌对阿奇霉素耐药率最高达100.00%,铜绿假单胞菌对亚胺培南耐药率最高为80.00%;大肠埃希菌对万古霉素耐药率最高为71.43%,肺炎克雷伯菌对万古霉素耐药率最高为57.14%,阴沟肠杆菌对氨曲南耐药率最高为83.33%。结论长期留置脑室引流管患者易发生颅内感染,随着引流管留置时间的延长,发生感染的概率升高,对感染的病原菌应按照药敏结果合理使用抗菌药物。OBJECTIVE To investigate the prevalence of intracranial infections in patients with long-term ventricular drainage tube indwelling so as to reduce the incidence of the intracranial infections.METHODS From Feb 2013 to Jun 2015,a total of 412 neurosurgery department patients who were treated with drainage after craniocerebral surgery were enrolled in the study,then the clinical data of the patients were retrospectively analyzed,the influence of the intubation sites and tube indwelling time on the incidence of intracranial infections in the patients with longterm ventricular drainage tube indwelling was observed,the distribution and drug resistance of the common species of pathogens causing the intracranial infections were analyzed,and the statistical analysis of data was performed with the use of SPSS 19.0software.RESULTS The infection rate of the patients with the intubation site of ventricle was 23.97%,significantly higher than that of the patients with other intubation sites（P0.05）.The infection rate was 5.50%in the patients with the indwelling time varying from 1to 2days,26.03%in the patients with the indwelling time varying from 3to 4days,41.67%in the patients with the indwelling time no less than 5days.Staphylococcus aureus,Pseudomonas aeruginosa,and Candida tropicalis were the major species of pathogens causing the intracranial infections,accounting for 27.14%,21.43%,and 12.86%,respectively.The drug resistance rates of S.aureus to aztreonam and penicillin were no less than 50.00%;the drug resistance rate of Streptococcus pneumoniae to azithromycin was as high as 100.00%;the drug resistance rate of P.aeruginosato imipenem was 80.00%;the drug resistance rate of Escherichia coli to vancomycin was 71.43%;the drug resistance rate of Klebsiella pneumoniae to vancomycin was 57.14%;the drug resistance rate of Enterobacter cloacae to aztreonam was 83.33%.CONCLUSION The patients with long-term ventricular drainage tube indwelling are at high risk of intracranial infections,the probability of the infections is incr

关 键 词：脑室引流管 颅内感染 病原菌 

分 类 号：R651.1[医药卫生—外科学]