脑胶质瘤手术患者术后颅内感染病原学特点及危险因素分析

发布时间：2018-03-01 13:18

本文关键词： 脑胶质瘤手术颅内感染病原菌危险因素　出处：《中华医院感染学杂志》2017年20期 　论文类型：期刊论文

【摘要】：目的探讨脑胶质瘤手术后颅内感染病原菌特点及危险因素。方法选取医院2008年1月-2016年12月收治的脑胶质瘤手术患者94例,回顾性分析颅内感染患者脑脊液培养病原菌分布和其对抗菌药物的耐药性及发生感染的危险因素。结果 94例脑胶质瘤手术患者术后颅内感染患者13例,感染率为13.83%;共分离培养病原菌36株,其中革兰阳性菌22例占61.11%,革兰阴性菌14例占38.89%;革兰阳性菌中金黄色葡萄球菌对红霉素、青霉素、四环素耐药率较高,分别为100.00%、90.00%、70.00%;表皮葡萄球菌对青霉素、四环素、红霉素耐药率较高,分别为100.00%、87.50%、75.00%;革兰阴性菌中肺炎克雷伯菌对头孢呋辛、氨苄西林耐药率较高,均为83.33%;鲍氏不动杆菌对氨苄西林、头孢呋辛耐药率较高,分别为100.00%、80.00%。年龄、手术时间、预防性抗菌药物为术后颅内感染的独立危险因素(P0.05)。结论脑胶质瘤手术患者术后颅内感染病原菌以革兰阳性菌居多,应根据药敏结果合理使用抗菌药物,并注意感染危险因素以降低感染率。
[Abstract]:Objective to investigate the pathogenic bacteria characteristics and risk factors of intracranial infection after glioma surgery. Methods 94 patients with glioma were selected from January 2008 to December 2016 in our hospital. The distribution of pathogenic bacteria in cerebrospinal fluid culture of patients with intracranial infection, the drug resistance to antibiotics and the risk factors of infection were analyzed retrospectively. Results there were 13 cases of intracranial infection after operation in 94 patients with glioma. The infection rate was 13.83%, 36 strains of pathogenic bacteria were isolated and cultured, of which 22 cases were Gram-positive bacteria (61.11%), 14 cases Gram-negative bacteria (38.89%), and the rate of resistance of Staphylococcus aureus to erythromycin, penicillin and tetracycline was higher in Gram-positive bacteria. The resistance rates of Staphylococcus epidermidis to penicillin, tetracycline and erythromycin were 100.00,87.50g and 75.00, respectively. Klebsiella pneumoniae showed higher resistance to cefuroxime and ampicillin in Gram-negative bacteria, all of which were 83.33; Acinetobacter baumannii was resistant to ampicillin. The drug resistance rate of cefuroxime was 100.0080.00.Age, operation time, prophylactic antibiotics were the independent risk factors of intracranial infection after operation (P 0.05). Conclusion Gram-positive bacteria are the main pathogens of intracranial infection in patients with glioma after operation. Antibiotics should be used rationally according to drug sensitivity and risk factors of infection should be paid attention to to reduce infection rate.
【作者单位】：宁波市医疗中心李惠利东部医院神经外科;
【基金】：宁波市自然基金资助项目(2012A610195)
【分类号】：R739.41

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