神经外科疾病患者合并急性化脓性脑室炎的病原菌分布与耐药性及相关因素分析

发布时间：2018-04-26 11:05

本文选题：神经外科 + 急性化脓性脑室炎　；参考：《中华医院感染学杂志》2017年15期

【摘要】：目的分析神经外科疾病患者并发急性化脓性脑室炎的病原菌分布、耐药性及相关因素影响,为临床神经外科并发急性化脓性脑室炎抗菌治疗提供参考依据。方法选取2013年8月-2015年9月于医院接受治疗的775例神经外科疾病患者,通过单因素、多因素分析神经外科疾病患者合并急性化脓性脑室炎的危险因素,通过病原菌鉴定和主要致病菌耐药性分析,优化抗菌疗法的合理方案。结果有51例患者并发急性化脓性脑室炎,感染率为6.58%;共分离出167株病原菌,以革兰阳性菌为主,共110株占65.87%;革兰阴性菌普遍对头孢他啶耐药,鲍氏不动杆菌具有多药耐药性;革兰阳性菌普遍对青霉素耐药,对万古霉素敏感;logistic多因素分析显示,幕下手术、手术时间4h、再次手术以及术后脑脊液漏是发生感染的独立危险因素(P0.05)。结论神经外科疾病患者并发急性化脓性脑室炎危险因素较多,且主要以革兰阳性菌致病率最高,其主要致病菌具有多耐药性,建议早期进行药敏检测以优化抗菌方案。
[Abstract]:Objective to analyze the distribution of pathogenic bacteria, drug resistance and related factors in patients with neurosurgical diseases complicated with acute suppurative ventricular inflammation, so as to provide a reference for clinical treatment of acute suppurative ventricular inflammation. Methods from August 2013 to September 2015, 775 patients with neurosurgical diseases were treated in hospital. The risk factors of neurosurgical diseases complicated with acute suppurative ventricular disease were analyzed by univariate and multivariate analysis. Through the identification of pathogenic bacteria and the analysis of drug resistance of main pathogenic bacteria, the rational plan of antimicrobial therapy was optimized. Results 51 patients were complicated with acute suppurative ventricular inflammation, the infection rate was 6.58, 167 pathogenic bacteria were isolated, 110 were Gram-positive bacteria (65.87g), Gram-negative bacteria were generally resistant to ceftazidime and Acinetobacter baumannii had multidrug resistance. Gram-positive bacteria were generally resistant to penicillin and were sensitive to vancomycin. Logistic multivariate analysis showed that subtentorial operation, operation time 4 h, reoperation and postoperative cerebrospinal fluid leakage were independent risk factors for infection. Conclusion there are many risk factors of acute suppurative ventricular inflammation in patients with neurosurgical diseases, and Gram-positive bacteria have the highest pathogenicity, and the main pathogenic bacteria have multidrug resistance. It is suggested that early detection of drug sensitivity should be carried out to optimize the antimicrobial regimen.
【作者单位】：南阳市中心医院神经外科;
【分类号】：R651

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