摘要
目的研究神经外科手术患者术后颅内感染病原菌及耐药性,为神经外科患者术后颅内感染治疗提供参考。方法选取2008年1月-2013年12月医院收治的800例神经外科手术患者作为研究对象,随机抽取新入院38例患者,对其手术第1、2、4、7天时头皮标本以常规方法进行病原菌及培养药敏结果,同时对感染患者的脑脊液检出的病原菌和药物敏感性进行分析。结果 800例神经外科手术患者共发生颅内感染50例,感染率6.25%;脑脊液培养出病原菌50株,以革兰阳性菌为主,共39株占78.00%;38例患者头皮培养检出病原菌146株,其中革兰阳性菌最多,其次为真菌及革兰阴性杆菌,分别占91.78%、4.11%及4.11%;患者脑脊液及头皮检出的革兰阳性菌对苯唑西林、青霉素的耐药率均较高,分别为87.18%、84.62%及94.78%、100.00%,对万古霉素耐药率均较低;脑脊液检出的革兰阴性菌对卡那霉素的耐药率最高,为54.55%,头皮检出的革兰阴性菌对头孢吡肟及头孢他啶的耐药率最高,均为100.00%。结论神经外科术后患者发生颅内感染由多种因素造成,脑脊液及头皮拭子培养均以革兰阳性菌多见,但局灶性颅内逆行感染是神经外科患者发生感染影响最大的因素。
OBJECTIVE To investigate the pathogens and drug resistance of postoperative intracranial infections in neurosurgical patients,so as to provide reference for treatment of postoperative intracranial infectiond in neurosurgical patients.METHODS Totally 800 cases of neurosurgical patients from Jan.2008 to Dec.2013 in our hospital were selected as research subjects.And 38 patients newly admitted to hospital were randomly selected to observe the culture and sensitivity results of scalp samples by conventional method at postoperative 1,2,4,7days,meanwhile,pathogens and drug sensitivity of cerebrospinal fluid（CSF）from infected patients were analyzed.RESULTS Totally 50 out of 800 neurosurgical patients had intracranial infections with the infection rate of 6.25%.The CSF culture detected 50 pathogens mainly including gram positive bacteria（39strains,78.00%）.The scalp culture for38 patients detected 146 pathogens mainly including gram positive bacteria（91.78%）,followed by fungi（4.11%）and gram negative bacilli（4.11%）.Gram positive bacteria from CSF and scalps had high resistances to oxacillin and penicillin,with resistances of 87.18%,84.62% and 94.78%,100.00%,while their resistances were low to vancomycin.Gram negative bacteria from CSF had the highest resistance of up to 54.55% to kanamycin,while gram negative bacteria from scalps were most resistant to cefepime and ceftazidime with resistances of 100.00%.CONCLUSIONPostoperative intracranial infections in neurosurgical patients is caused by several factors.For neurosurgical patients,gram positive bacteria are common in CSF and scalp swab culture,but the focal retrograde intracranial infection is the greatest factor affecting infections in neurosurgical patients.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第8期1741-1743,共3页
Chinese Journal of Nosocomiology
基金
浙江省医学会临床科研外科专项基金资助项目(2010ZYC-A29)
关键词
神经外科
颅内感染
脑脊液
病原菌
耐药性
Neurosurgery
Intracranial infection
Influencing factors
Cerebrospinal fluid
Pathogen
Drug resistance
