摘要
目的分析临床患者脑脊液病原菌的分布特点和耐药情况,为临床合理用药及预防提供参考。方法对医院2017年1月—2019年12月住院患者送检的脑脊液标本,用WHONET 5.6软件进行统计分析病原菌的分布和耐药性。结果336株病原菌主要分布在神经外科(61.60%)、新生儿科(15.77%)、神经内科(9.23%)和重症医学科(6.55%);其中革兰阳性菌(285株,84.83%)检出率显著高于革兰阴性菌(37株,11.01%)、真菌(14株,4.17%);革兰阳性菌以凝固酶阴性葡萄球菌、金黄色葡萄球菌和肺炎链球菌为主,未发现对万古霉素、替考拉宁、利奈唑胺耐药菌株;革兰阴性菌主要为大肠埃希菌和肺炎克雷伯菌,对阿米卡星、亚胺培南、美罗培南、哌拉西林/他唑巴坦、阿莫西林/克拉维酸、头孢派酮/舒巴坦耐药率低,鲍曼不动杆菌对常用的抗菌药物几乎全部耐药;真菌以新型隐球菌为主,对常见抗真菌药均敏感。结论2017—2019年我院患者脑脊液病原菌以凝固酶阴性葡萄球菌为主,耐药情况较严重。了解本地区脑脊液病原菌的分布和耐药情况,对预防多重耐药菌的产生及合理选择抗菌药物具有重要的指导意义。
Objective To analyze the distribution characteristics and drug resistance of pathogenic bacteria in cerebrospinal fluid(CSF)of clinical patients,so as to provide reference for rational clinical drug use and prevention.Methods Cerebrospinal fluid samples of inpatients from January 2017 to December 2019 were statistically analyzed by WHONET 5.6 software for the distribution and drug resistance of pathogenic bacteria.Results Three hundred and thirty-six strains of pathogenic bacteria were mainly distributed in Neurosurgery Department(61.60%),Neonatology Department(15.77%),Neurology Department(9.23%)and Department of Critical Care Medicine(6.55%).The detection rate of Gram-positive bacteria(285 strains,84.83%)was significantly higher than that of Gram-negative bacteria(37 strains,11.01%)and that of fungi(14 strains,4.17%).The Gram-positive bacteria were mainly coagulase negative staphylococcus,staphylococcus aureus and streptococcus pneumonia.No strains resistant to Vancomycin,Teikoranin or Linezolid were found.Gram-negative bacteria were mainly Escherichia coli and Klebsiella pneumoniae,and had low drug resistance rates to Amikacin,Imipenem,Meropenem,Piperacillin/Tazobactam,Amoxicillin/Clavulanic Acid,Cefperidone/Sulbactam.Acinetobacter baumannii was resistant to almost all common antibacterial drugs.Cryptococcus neofordii was the main fungus and was sensitive to common antifungal agents.Conclusion From 2017 to 2019,coagulase-negative staphylococcus was the main pathogenic bacteria in the cerebrospinal fluid of patients in our hospital,with serious drug resistance.Understanding the distribution and drug resistance of pathogenic bacteria in cerebrospinal fluid in corresponding region is of great significance for preventing the emergence of multi-drug resistant bacteria and for rationally selecting antimicrobial agents.
作者
邓懋清
陈丽萍
张晓曼
Deng Maoqing;Chen Liping;Zhang Xiaoman(Department of Clinical Laboratory,Longyan First Hospital Affiliated to Fujian Medical University,Longyan 364000,Fujian,China;Department of Ophtalmology,Longyan First Hospital Affiliated to Fujian Medical University,Longyan 364000,Fujian,China)
出处
《右江民族医学院学报》
2020年第4期419-422,共4页
Journal of Youjiang Medical University for Nationalities
关键词
脑脊液
病原菌
耐药性
cerebrospinal fluid
pathogenic bacteria
drug resistance
