中枢神经系统(脑脊液)感染病原菌分布特点及耐药性  

Characteristics and Drug Resistance of Pathogens Causing Central Nervous System (Cerebrospinal fluid) Infection

作　　者：邢吉燕[1] 张华[1] 罗湘蓉[1] 胡方芳[1] 许永杰 蒲海[1] 李红凌[1] 卢志顺 金婷婷[1] 李琴 刘家玲[1] 陈瑢 Xing Ji-yan;Zhang Hua;Luo Xiang-rong;Hu Fang-fang;Xu Yong-jie;Pu Hai;Li Hong-ling;Lu Zhi-sun;Jing Ting-ting;Li Qing;Liu Jia-ling;Chen Rong(Guizhou Provincial People's Hospital,Guiyang 550001)

机构地区：[1]贵州省人民医院,贵阳550001

出　　处：《国外医药（抗生素分册）》2021年第6期372-376,共5页World Notes on Antibiotics

摘　　要：目的探讨中枢神经系统感染病原菌分布与耐药性。方法选取贵州省人民医院2014年—2019年收治的中枢神经系统感染患者脑脊液标本,进行病原菌鉴定及药物敏感试验。结果共分离出350株病原菌,主要来源于神经外科(35.1%)、儿内科(14.3%)、儿科重症(13.1%)、神经内科(10.3%)及ICU(5.1%)。350株病原菌中,革兰阳性菌182株,占52%;革兰阴性菌168株,占48%。革兰阳性菌中屎肠球菌和粪肠球菌对青霉素G耐药率为10%以上、对利福平、红霉素、四环素耐药率60%以上,对万古霉素、利奈唑胺耐药率低。革兰阴性菌中大肠埃希菌对青霉素类、头孢菌素类、喹诺酮类、复方磺胺甲恶唑、四环素耐药率达65.0%以上,对碳青霉烯类敏感。鲍曼不动杆菌对常用的抗菌药物耐药率较高。结论了解中枢神经系统感染病原菌及耐药性,对指导临床合理使用抗菌药物具有重要意义。Objective To investigate the distribution and drug resistance of pathogens in central nervous system infection.Methods CSF samples of patients with central nervous system infection in Guizhou Provincial People’s Hospital from 2014 to 2019 were selected for pathogen identification and drug sensitivity test.Results A total of 350 strains of pathogens were isolated,mainly from neurosurgery (35.1%),pediatrics (14.3%),pediatrics (13.1%),neurology (10.3%) and ICU (5.1%).Among 350 strains of pathogens,182 strains were gram positive,accounting for 52%;168 strains were gram negative,accounting for 48%.Among the Gram-positive bacteria,Enterococcus faecium and Enterococcus faecalis were more than 10% resistant to penicillin G,more than 60% resistant to rifampicin,erythromycin and tetracycline,and less resistant to vancomycin and linezolid.The resistance rate of Escherichia coli to penicillins,cephalosporins,quinolones,sulfamethoxazole and tetracycline was more than 65.0%,and it was sensitive to carbapenems.Acinetobacter baumannii has a high resistance rate to commonly used antibiotics.Conclusion Understanding the pathogens and drug resistance of central nervous system infection is of great significance to guidethe rational use of antibiotics in clinic.

关 键 词：中枢神经系统 细菌耐药性 脑脊液 病原菌 

分 类 号：R978.1[医药卫生—药品]