我院2011-2014年化脓性脑膜炎患者脑脊液病原菌分布及耐药性分析  

Analysis of Pathogen Distribution and Drug Resistance of Cerebrospinal Fluid in Pyogenic Encephalitis Patients in Our Hospital during 2011-2014

作　　者：拜年 贾樱樱 高玉娟[1] 

机构地区：[1]新疆医科大学第一附属医院药学部,乌鲁木齐830054 [2]新疆医科大学第二附属医院药剂科,乌鲁木齐830063

出　　处：《中国药房》2016年第17期2345-2347,共3页China Pharmacy

摘　　要：目的:分析我院化脓性脑膜炎病原菌的分布及耐药特点,为抗菌药物的合理使用提供参考。方法:对我院2011年1月1日-2014年12月31日送检的4 255例化脓性脑膜炎住院患者脑脊液病原菌进行培养、鉴定和药敏试验。结果:共分离出834株病原菌,检出阳性率为19.6%,包括革兰氏阳性菌576株,占69.1%;革兰氏阴性菌255株,占30.6%;真菌3株,占0.4%。革兰氏阳性菌排前3位的是凝固酶阴性葡萄球菌(436株)、金黄色葡萄球菌(56株)和肠球菌属(29株);革兰氏阴性菌排前3位的是肺炎克雷伯菌(46株)、鲍曼不动杆菌(38株)和大肠埃希菌(31株)。病原菌分布科室前3位是神经外科(506株)、重症监护病房(169株)和呼吸重症科(64株)。药敏试验结果显示,葡萄球菌和肠球菌属对万古霉素、替考拉宁和米诺环素未发现耐药菌株;非发酵革兰氏阴性杆菌对米诺环素耐药率较低。结论:我院化脓性脑膜炎患者脑脊液细菌感染病原菌检出率以革兰氏阳性菌为主,各种致病菌耐药状况严重,临床应根据药敏情况合理选择抗菌药物。OBJECTIVE：To analyze the distribution and drug resistance of pyogenic encephalitis in our hospital,and to provide reference for rational use of antibiotics. METHODS：The cerebrospinal fluid pathogen of 4 255 patients with pyogenic encephalitis in our hospital during Jan. 1st,2011-Dec. 31 st,2014 were cultured and identified,and drug sensitivity test was conducted. RESULTS：A total of 834 pathogens were isolated with positive detection rate of 19.6%,including 576 strains of gram-positive bacteria,accounting for 69.1%;255 strains of gram-negative bacteria,accounting for 30.6%;3 strains of fungi,accounting for 0.4%.Top 3 gram-positive bacteria were Coagulase-negative staphylococci（436 strains）,Staphylococcus aureus（56 strains）and Enterococcus（29 strains）. Top 3 gram-negative bacteria were Klebsiella pneumoniae（46 strains）,Acinetobacter baumannii（38 strains）and Escherichia coli（31 strains）. Top 3 departments were neurosurgery department（506 strains）,ICU（169 strains）and severe respiratory disease department（64 strains）. Results of drug sensitivity test showed that no drug-resistant Staphylococcus and Enterococcus strains to vancomycin,teicoplanin and miuocycline was found;nonfermenting Gram-negative bacilli showed low resistant to minocycline. CONCLUSIONS：Gram-positive bacteria dominates the detection rate of cerebrospinal fluid of pyogenic encephalitis patients;drug resistance of various pathogens is serious and clinicians should choose antibiotics based on drug sensitivity.

关 键 词：化脓性脑膜炎 脑脊液 病原菌分布 耐药性 

分 类 号：R978.1[医药卫生—药品]