神经外科院内颅内感染细菌分布及抗生素敏感率的变化

发布时间：2018-04-13 13:07

本文选题：颅内感染 + 脑脊液细菌分布　；参考：《山西医科大学》2015年硕士论文

【摘要】：目的:监测神经外科颅内感染患者的脑脊液细菌分布情况及常用抗生素敏感率的变化,为治疗颅内感染经验使用抗生素提供依据。方法:查找、收集2012年1月~2014年12月山西医科大学第一医院神经外科行外科干预后发生颅内感染且脑脊液细菌培养阳性患者的相关数据,回顾性分析脑脊液病原菌分布及抗生素敏感率,逐年对比病原菌分布及药物敏感率变化,以SPSS17.0软件进行分析。结果:脑脊液分离菌株75株,包括革兰阳性菌51株(68%),主要为凝固酶阴性葡萄球菌,对万古霉素、利奈唑胺全部敏感;革兰阴性菌21株(32%),三年间构成比依次为13%、32%、48.1%,明显呈逐年增多趋势(P0.05),包括肺炎克雷伯杆菌14株,鲍曼不动杆菌4株,其中肺炎克雷伯杆菌抗生素敏感率低,鲍曼不动杆菌呈泛耐药状态,常用抗生素中,本研究所收集的革兰氏阴性菌对头孢曲松敏感率呈逐年下降趋势(P0.05),其余抗生素如头孢他啶、头孢哌酮、美罗培南、米诺环素敏感率差异无统计学意义。结论:外科干预后发生颅内感染中革兰氏阳性菌仍占主要部分,但革兰氏阴性菌构成比呈逐年上升趋势,在经验使用抗生素时,应注意联合用药,防止患者耐药性的增加以及自身菌群失调,降低患者不良预后的风险。
[Abstract]:Objective: to monitor the distribution of bacteria in cerebrospinal fluid (CSF) of patients with intracranial infection in neurosurgery and the change of antibiotic sensitivity rate in common use in order to provide evidence for the use of antibiotics in the treatment of intracranial infection.Methods: from January 2012 to December 2014, data of patients with intracranial infection and positive cerebrospinal fluid culture were collected after neurosurgery intervention in the first Hospital of Shanxi Medical University, Shanxi Medical University.The distribution of pathogenic bacteria and antibiotic susceptibility rate in cerebrospinal fluid were analyzed retrospectively. The distribution of pathogenic bacteria and the change of drug sensitivity rate were compared year by year. The results were analyzed by SPSS17.0 software.Results: Seventy-five strains isolated from cerebrospinal fluid, including 51 Gram-positive strains, were mainly coagulase-negative staphylococci and were all sensitive to vancomycin and linazolamine.Acinetobacter baumannii was pan-resistant. Among the commonly used antibiotics, the susceptibility rate of Gram-negative bacteria to ceftriaxone decreased year by year, and the other antibiotics such as ceftazidime, cefoperazone, meropenem were decreased year by year.There was no significant difference in the sensitivity of minocycline.Conclusion: Gram-positive bacteria still account for the main part of intracranial infection after surgical intervention, but the composition ratio of Gram-negative bacteria is increasing year by year.To prevent the increase of drug resistance and dysbacteriosis and reduce the risk of poor prognosis.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R742.9

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