摘要
目的通过观察医院神经外科术后颅内感染患者临床资料,探讨分析脑脊液的病原菌分布特点以及耐药性,以期为临床预防神经外科术后颅内感染及合理用药提供帮助。方法回顾性分析2008年1月-2012年1月医院收治的886例神经外科接受手术治疗患者的临床资料,分析其术后颅内感染的发生率;根据术前是否有脑部受损因素,将神经外科术后颅内感染患者分为脑外伤组和非脑外伤组,对比观察两组患者的病原菌分布及耐药性,采用SPSS17.0软件进行统计分析。结果 886例患者术前均未出现颅内感染,术后共检出颅内感染患者136例,感染率为15.35%;脑外伤组革兰阴性菌28株占41.18%,革兰阳性菌40株占58.82%,非脑外伤组革兰阴性菌20株占29.41%,革兰阳性菌占70.59%;脑外伤组革兰阴性菌显著高于非外伤组患者(P<0.05),而革兰阳性菌显著低于非脑外伤组患者(P<0.05)。结论不同因素致伤患者的病原菌构成比差异显著,病原菌的耐药性各不相同,临床上应根据具体病情与脑脊液病原菌检测结果,合理使用抗菌药物。
OBJECTIVE To observe the clinical data of patients with postoperative intracranial infections in department of neurosurgery and explore the distribution and drug resistance of pathogens isolated from cerebral spinal fluid so as to provide guidance for clinical prevention of the postoperative intracranial infections as well as the rea- sonable use of antibiotics. METHODS The clinical data of 886 patients who receivedsurgery in the department of neurosurgery from Jan 2008 to Jan 2012 were retrospectively analyzed, then the incidence of postoperative in- tracranial infections was analyzed, the patients with postoperative intracranial infections were divided into the brain injury group and the non-brain injury group according to the factors for cerebral damage before surgery, the distri- bution and drug resistance of the pathogens were observed and compared between the two groups, and the statisti- cal analysis was performed with the use of SPSS17.0 software. RESULTS Of the 886 patients enrolled in the study, the intraeranial infections did not occur before the surgery but occurred in 136 cases after the surgery with the in- fection rate of 15.35%. There were 28 （41.18%） strains of gram-negative bacteria and 40 （58.82%） strains of gram-positive bacteria isolated from the brain injury group; there were 20 （29.41%） strains of gram-negative bac- teria and the gram-positive bacteria （70.59%） isolated from the non-brain injury group; the isolation rate of the gram-negative bacteria was significantly higher in the brain injury group than in the non-brain injury group （P〈 0.05）, while the isolation rate of the gram-positive bacteria was significantly lower in the brain injury group than in the non-brain injury group （P〈0.05）： CONCLUSION The distribution of the pathogens varies significantly in the patients with brain juries induced by different factors, and the pathogens differ in the drug resistance. It is nec- essary to reasonably use antibiotics according to the specific condition and the result of culture of cerebrospinal fluid.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第10期2372-2374,共3页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生科技基金项目(2010KYB134)
关键词
神经外科
颅内感染
脑脊液
耐药性
试验分析
Department of neurosurgery
Intracranial infection
Cerebrospinal fluid
Drug resistance
Test analysis
