鼻源性颅内感染细菌学分布及药敏特征

发布时间：2019-02-15 19:05

【摘要】：目的:主要探讨鼻源性颅内感染的细菌学分布和药敏特征,及其与慢性鼻窦炎患者的细菌性分布之间的关系,为临床上早期经验性选择抗生素提供参考。方法:收集2009年1月—2017年1月我院神经外科鼻源性颅内感染脓液或脑脊液细菌培养阳性患者数据,同步收集2016年4月—2017年1月我院耳鼻喉科慢性鼻窦炎患者鼻及鼻窦拭子细菌培养阳性数据,分析两组数据细菌学分布特点和药敏特征。结果:5例鼻源性颅内感染患者培养出致病菌5株,其中G+菌有4株,分别是粪肠球菌、草绿色链球菌、棒状杆菌、凝固酶阴性葡萄球菌(MRSCON+),G-菌1株,为肺炎克雷伯杆菌;42例慢性鼻窦炎致病菌57株,其中15例患者是两种细菌的混合感染,G+菌有49株,其中葡萄球菌29株,G-菌有8株。两组患者细菌学分布具有相关性,G+对万古霉素和利奈唑胺高度敏感,且对红霉素都有较高的耐药率。结论:通过回顾性分析两组疾病细菌培养数据,得出以下结论:1.G+菌是鼻源性颅内感染和慢性鼻窦炎主要致病菌,G-菌也占有一定的比例,经验性治疗时应该两种细菌并重。2.两组疾病对万古霉素和利奈唑胺高度敏感,且对红霉素都有较高的耐药率,经验性用药时要综合考虑药物敏感性和耐药性。3.鼻源性颅内感染和慢性鼻窦炎常见致病菌种类分布上有一致性,革兰阳性菌和阴性菌构成比无统计学差异。
[Abstract]:Objective: to investigate the bacteriological distribution and drug sensitivity of rhinogenic intracranial infection and its relationship with bacterial distribution in patients with chronic sinusitis, so as to provide a reference for clinical experience in the selection of antibiotics. Methods: data were collected from January 2009 to January 2017 in patients with sepsis or cerebrospinal fluid culture positive from neurosurgery nasogenic intracranial infection in our hospital. The bacterial culture positive data of nasal and nasal swabs in patients with chronic sinusitis in our hospital from April 2016 to January 2017 were collected simultaneously. The bacteriological distribution and drug sensitivity of the two groups were analyzed. Results: five strains of pathogenic bacteria were isolated from 5 patients with rhinogenic intracranial infection. Among them, 4 strains were Enterococcus faecalis, streptococcus grass green, 1 strain of Corynebacterium and 1 strain of (MRSCON), G- bacteria of coagulase-negative staphylococcus. Klebsiella pneumoniae; There were 57 strains of pathogenic bacteria in 42 cases of chronic sinusitis, of which 15 cases were mixed infection of two kinds of bacteria. There were 49 strains of G bacteria, including 29 strains of staphylococcus and 8 strains of G- bacteria. G was highly sensitive to vancomycin and linazolamide and had high resistance to erythromycin. Conclusion: through the retrospective analysis of the bacterial culture data of the two groups of diseases, the following conclusions can be drawn: 1. G bacteria are the main pathogens of rhinogenic intracranial infection and chronic sinusitis, and G- bacteria also account for a certain proportion. Empirical therapy should be given equal weight to both bacteria. 2. 2. The two groups were highly sensitive to vancomycin and linazolamide and had high resistance to erythromycin. The distribution of common pathogenic bacteria in rhinogenic intracranial infection and chronic sinusitis was consistent, but there was no statistical difference between Gram-positive bacteria and negative bacteria.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R446.5;R742.9

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