颅脑损伤患者脑积水分流术后感染病原菌与耐药性监测

发布时间：2018-06-17 00:13

本文选题：颅脑损伤 + 脑积水分流术　；参考：《中华医院感染学杂志》2016年09期

【摘要】：目的研究颅脑损伤患者脑积水分流术后感染病原菌分布及耐药性,为降低感染率提供依据。方法选取2014年12月-2015年12月医院诊治的498例颅脑损伤行脑积水分流术患者资料进行分析,分析颅脑损伤患者脑积水分流术后感染病原菌分布及其耐药性;采用SPSS18.0软件进行统计分析。结果 498例颅脑损伤患者中41例术后发生感染,感染率为8.23%;41例患者中共检出病原菌59株,其中革兰阴性菌18株占30.51%,革兰阳性菌18株占30.51%,真菌23株占38.98%;革兰阴性菌中阴沟肠杆菌对头孢吡肟、头孢噻肟耐药率较高,分别占90.0%和80.0%;不动杆菌属对头孢噻肟和左氧氟沙星耐药率较高,均为100.00%;革兰阳性菌中棒杆菌属对氨苄西林、头孢噻肟耐药率较高,均为75.0%;白色假丝酵母菌对红霉素、伊曲康唑和氟康唑的耐药率较高,分别为88.89%和55.56%;光滑假丝酵菌对伊曲康唑、氟康唑耐药率较高,分别为71.43%和57.14%。结论颅脑损伤患者脑积水分流术后感染率较高,病原菌以真菌为主,且耐药率较高,应加强病原菌药敏试验,选择敏感抗菌药物进和治疗,以提高临床治愈率。
[Abstract]:Objective to study the distribution and drug resistance of pathogenic bacteria after hydrocephalus shunt in patients with craniocerebral injury. Methods the data of 498 patients with craniocerebral injury undergoing hydrocephalus shunt from December 2014 to December 2015 were analyzed, and the distribution of pathogenic bacteria and their drug resistance after hydrocephalus shunt operation were analyzed. SPSS 18.0 software was used for statistical analysis. Results among the 498 patients with craniocerebral injury, 41 cases developed infection after operation, and the infection rate was 8.23%. A total of 59 strains of pathogenic bacteria were detected in 41 cases of craniocerebral injury. Among them, 18 Gram-negative bacteria accounted for 35.51%, 18 Gram-positive bacteria 30.51 and 23 fungi 38.98.The resistance rate of Enterobacter cloacae to cefepime, cefotaxime was higher in Gram-negative bacteria. Acinetobacter has a higher resistance rate to cefotaxime and levofloxacin, both 100.00. among Gram-positive bacteria, Corynebacterium and cefotaxime have higher resistance to ampicillin and cefotaxime, and Candida albicans are resistant to erythromycin. The drug resistance rates of itraconazole and fluconazole were 88.89% and 55.56, respectively, and the rates of resistance to itraconazole and fluconazole were 71.43% and 57.14%, respectively. Conclusion the infection rate of patients with craniocerebral injury after hydrocephalus shunt is higher, the pathogenic bacteria are mainly fungi, and the drug resistance rate is high. We should strengthen the susceptibility test of pathogenic bacteria, select sensitive antimicrobial agents to enter and treat, so as to improve the clinical cure rate.
【作者单位】：四川医科大学第一附属医院神经外科;绵阳市四零四医院神经外科;绵阳市第三人民医院神经外科;解放军第520医院神经外科;
【基金】：四川省卫生厅科研基金资助项目(120296)
【分类号】：R651.15

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