2014-2021年中老年群体中枢神经系统感染流行性特征及耐药性分析  

Epidemiological characteristics and drug resistance analysis of central nervous system infections in elderly populations from 2014 to 2021

作　　者：王兴宇 马立聪 常燕琴[1] 高洪波[1] 张晶[3] WANG Xingyu;MA Licong;CHANG Yanqin;GAO Hongbo;ZHANG Jing(School of Basic Medicine and Forensic Medicine,Baotou Medical College,Baotou 014040,China;Department of Pathology,The Second Affiliated Hospital of Baotou Medical College;Department of Laboratory Medicine,Baotou Central Hospital)

机构地区：[1]包头医学院基础医学与法医学院,内蒙古包头014040 [2]包头医学院第二附属医院病理科 [3]包头市中心医院检验科

出　　处：《包头医学院学报》2023年第6期72-77,87,共7页Journal of Baotou Medical College

基　　金：2022年内蒙古自治区教育厅高等学校科学技术研究项目(NJZY22052)。

摘　　要：目的:了解中老年中枢神经系统感染(CNSI)患者的病原体流行性特征和药物敏感性、耐药性。方法:收集2014年至2021年共105例脑脊液(CSF)培养阳性的中老年CNSI患者的脑脊液样本进行微生物鉴定和药敏研究。使用Pheonix100系统鉴定分离的病原体,使用K-B(圆盘扩散)法测定分离株的抗菌敏感性。结果:在分离株中,革兰氏阳性菌、革兰氏阴性菌分别占69.52%、30.48%。流行病学研究调查表明脑脊液阳性患者在不同年龄中存在显著性差异(P<0.05),在45~60岁患者中表皮葡萄球菌含量最多;在≥60岁患者中,鲍曼不动杆菌(25.0%)感染率最高。葡萄球菌属菌株对利奈唑胺、万古霉素敏感率均为100%;鲍曼不动杆菌对头孢哌酮/舒巴坦、多黏菌素B更敏感;肺炎克雷伯菌属对亚胺培南、美罗培南的敏感性更强。结论:临床可根据不同细菌的耐药特征合理选择抗菌药物。Objective:To investigate the epidemic characteristics of pathogens,drug sensitivity and drug resistance in middle-aged and elderly patients with central nervous system infection(CNSI).Methods:A total of 105 middle-aged and elderly patients with cerebrospinal fluid(CSF)culture positive from 2014 to 2021 were collected for microbial identification and drug sensitivity study.Pheonix100 system was used to identify the isolated pathogens,and K-B(disk diffusion)method was used to determine the antibacterial sensitivity of the isolates.Results:Among the isolates,Gram-positive and Gram-negative bacteria accounted for 69.52%and 30.48%,respectively.Epidemiological investigation showed that cerebrospinal fluid positive patients in different ages had significant differences(P<0.05).Staphylococcus epidermidis content was the highest in patients 45-60 years old.In patients 60 and more than 60 years old,the infection rate of Acinetobacter baumannii(25.0%)was the highest.The sensitive rates of Staphylococcus strains to linezolid and vancomycin were 100%.Acinetobacter baumannii was more sensitive to cefoperazone/sulbactam and polymyxin B.Klebsiella pneumoniae was more sensitive to imipenem and meropenem.Conclusion:The clinical selection of antibiotics can be based on the resistance characteristics of different bacteria.

关 键 词：中老年群体 脑脊液 细菌培养 耐药性 流行病学特征 

分 类 号：R742.9[医药卫生—神经病学与精神病学]