摘要
目的:分析颅脑外伤患者开颅术后颅内感染的病原菌分布及耐药性,为制订合理的抗感染治疗方案提供研究依据。方法:选取2015年6月~2018年6月的49例颅脑外伤开颅手术术后颅内感染患者作为研究对象,对其脑脊液样本中的病原菌分布及耐药性进行检测和分析。结果:检出65株病原菌,其中,革兰阴性菌38株占58.46%,革兰阳性菌22株占33.85%,真菌5株占7.69%,铜绿假单胞菌、大肠埃希菌、金黄色葡萄球菌为主要病原菌,构成比分别为23.08%、15.38%、15.38%。革兰阴性菌对头孢吡肟、头孢呋辛、头孢哌酮、阿米卡星、左氧氟沙星等的耐药率较高,未检出针对亚胺培南或利奈唑胺耐药的革兰阴性菌株。革兰阳性菌对青霉素G、苯唑西林、头孢哌酮、四环素、左氧氟沙星等的耐药率较高,未检出针对万古霉素或替考拉宁耐药的革兰阳性菌株。结论:颅脑外伤开颅手术术后感染的病原菌以革兰阴性菌为主,病原菌对于多种抗菌药物具有较高的耐药率,临床医生应根据病原菌分布特征和药敏试验结果,选取敏感性抗菌药物进行抗感染治疗,以达到提高疗效、减少耐药、改善预后的效果。
Objective To analyze the distribution and drug resistance of the pathogenic bacteria of the patients with traumatic brain injury complicated with intracranial infections after craniotomy to provide the basis for formulating a reasonable anti-infection treatments plan.Methods 49 cases of patients with traumatic brain injury complicated with intracranial infections after craniotomy from June of 2018 to June of 2015 were selected as the research subjects.The distribution and drug resistance of the pathogenic bacteria in the cerebrospinal fluid samples of the patients were detected and analyzed.Results 65 strains of pathogenic bacteria were detected.among them,38 strains were Gram-negative bacteria accounting for 58.46%,22 strains were Gram-positive bacteria accounting for 33.85%,5 strains were fungi accounting for 7.69%.Pseudomonas aeruginosa,Escherichia coli and Staphylococcus aureus were the main pathogenic bacteria,and the constituent ratios were 23.08%,15.38%,15.38%respectively.The drug resistant rates of the main Gram-negative bacteria to cefepime,cefuroxime,cefoperazone,amikacin,levofloxacin were higher,and no Gram-negative strain resistant to imipenem or linezolid was detected.The drug resistant rates of the main Gram-positive bacteria to penicillin G,oxacillin,cefoperazone,tetracycline and levofloxacin were higher.No Gram-positive strain resistant to vancomycin or teicoplanin was detected.Conclusions The pathogenic bacteria of the patients with traumatic brain injury complicated with intracranial infections after craniotomy are mainly Gram-negative bacteria,and the pathogenic bacteria have high drug resistance rates for many kinds of antibiotics.The clinicians should choose sensitive antibiotics according to the distribution characteristics of the pathogenic bacteria and the results of drug sensitivity test,so as to achieve the effects of improving the curative effects,reducing the drug resistance and improving the prognosis.
作者
王建星
柳成荫
Wang Jian-xing;Liu Cheng-yin(ICU,Pinggu hospital Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 101200,China;Department of Neurosurgery,Pinggu hospital Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 101200,China)
出处
《晓庄学院学报（医学版）》
2020年第2期72-75,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
颅脑外伤
开颅手术
术后颅内感染
病原菌分布
耐药性
traumatic brain injury
craniotomy
postoperative intracranial infection
distribution of pathogenic bacteria
drug resistance
