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目的调查本院973份脑脊液标本病原菌的检出率及耐药谱,为临床诊断和合理用药提供依据。方法采用VITEK全自动微生物分析仪进行菌种鉴定和药敏试验。结果 973份脑脊液标本中,分离出病原菌153株,阳性率为15.7%,前5位分离菌种为凝固酶阴性葡萄球菌、鲍曼不动杆菌、肠球菌属、新型隐球菌和肺炎克雷伯菌,分别占32.7%、15.0%、11.1%、10.5%和9.8%。金黄色葡萄球菌对青霉素G的耐药率达100.0%,对红霉素、苯唑西林和克林霉素的耐药率高达80.0%。凝固酶阴性葡萄球菌对青霉素G、红霉素、苯唑西林的耐药率达70.0%以上。屎肠球菌对莫西沙星、红霉素、左旋氧氟沙星等耐药率高达70.0%以上。鲍曼不动杆菌对亚胺培南和厄他培南的耐药率分别为54.5%和100.0%。肺炎克雷伯菌对环丙沙星、头孢曲松、氨苄西林/舒巴坦等的耐药率达60.0%以上。结论脑脊液标本病原菌以革兰阳性菌多见,鲍曼不动杆菌在革兰阴性菌中占首位,新型隐球菌占一定比例。本研究为中枢神经系统感染的预防和经验性抗菌药物治疗提供可靠的数据资料。
Objective To investigate the detection rate and drug resistance spectrum of 973 CSF samples in our hospital and provide the basis for clinical diagnosis and rational drug use. Methods VITEK automatic microbiological analyzer for strain identification and drug susceptibility testing. Results Among the 973 CSF samples, 153 strains of pathogens were isolated, the positive rate was 15.7%. The top 5 isolates were coagulase negative Staphylococcus aureus, Acinetobacter baumannii, Enterococcus faecalis, Cryptococcus neoformans and Klebsiella pneumonia Accounting for 32.7%, 15.0%, 11.1%, 10.5% and 9.8% respectively. Staphylococcus aureus resistant to penicillin G rate of 100.0%, erythromycin, oxacillin and clindamycin resistance rate up to 80.0%. Coagulase negative staphylococcus penicillin G, erythromycin, oxacillin resistance rate of 70.0%. Enterococcus faecium to moxifloxacin, erythromycin, levofloxacin and other resistance rates as high as 70.0%. Acinetobacter baumannii resistance rates to imipenem and ertapenem were 54.5% and 100.0%, respectively. Klebsiella pneumoniae ciprofloxacin, ceftriaxone, ampicillin / sulbactam resistance rate of 60.0% or more. Conclusion Gram-positive bacteria are most common in cerebrospinal fluid samples. Acinetobacter baumannii is the most common gram-negative bacterium, and Cryptococcus neoformans accounts for a certain proportion. This study provides reliable data for the prevention of central nervous system infections and the treatment of empirical antibiotics.