摘要
目的分析神经外科病原菌分布和抗菌药物敏感性,为抗菌药物的合理使用提供实验室参考依据。方法选取西安交通大学第一附属医院2012年1月至2014年9月神经外科送检标本进行病原菌分离、培养,采用全自动微生物分析仪进行菌种鉴定,采用仪器法和纸片法检测其对抗菌药物的敏感性,用WHONET5.6软件进行统计分析。结果共分离非重复病原菌1 319株,其中革兰阳性菌482株(36.6%),革兰阴性菌797株(60.4%),真菌40株(3.0%)。病原菌主要分离自痰液、脑脊液、尿液和血液标本,以金黄色葡萄球菌、鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌最为常见。分离的革兰阳性菌与革兰阴性菌均呈不同程度的耐药,金黄色葡萄球菌仅对利奈唑胺、万古霉素敏感率为100.0%,鲍曼不动杆菌对碳青霉烯类抗菌药物的耐药率已高于80.0%,肺炎克雷伯菌出现对碳青霉烯类抗菌药物的耐药现象。尚未发现耐碳青霉烯类抗菌药物的大肠埃希菌,铜绿假单胞菌对哌拉西林/他唑巴坦敏感率达到90.0%以上。结论神经外科感染以革兰阴性菌为主,但金黄色葡萄球菌最为常见,多重耐药菌与泛耐药菌日趋增多,临床合理使用抗菌药物进行抗感染治疗至关重要。
Objective To analyse pathogens distribution and antibacterial susceptibility of bacteria isolated from clinical speci‐mens in neurosurgery ,in order to provide laboratory basis for rational use of antibacterial agents .Methods Isolation and culturing of bacteria were carried out in various clinical samples collected in neurosurgery from January 2012 to September 2012 in the First Affiliated Hospital of Xi′an Jiaotong University ,all strains were identified by using automatic microbial analyzer ,and the sensitivi‐ties to antibacterial agents were verified by using instrument method and K‐B method .WHONET5 .6 software was used for data a‐nalysis .Results A total of 1 319 strains of non‐repeating pathogenic bacteria were isolated ,including 482 strains （36 .6% ） of gram‐positive bacteria ,797 strains （60 .4% ） of gram‐negative bacteria ,and 40 strains （3 .0% ） of fungi .Most of pathogenic bacteria were isolated from sputum ,cerebrospinal fluid ,urine and blood specimens ,and the most common isolates were Staphylococcus aureus , Acinetobacter baumannii ,Klebsiella pneumoniae ,Pseudomonas aeruginosa and Escherichia coli .Isolated gram‐positive bacteria and gram‐negative bacteria were resistant to antibacterial agents in different degree .The sensitivity rate was 100 .0% only in linezolid and vancomycin against Staphylococcus aureus .The resistant rates of carbapenems against Acinetobacter baumannii were higher than 80 .0% ,and carbapenems‐resistant Klebsiella pneumoniae strains had also appeared .Carbapenems‐resistant Escherichia coli strains had not yet been found .The sensitive rate of Piperacillin‐Tazobactam against Pseudomonas aeruginosa was above 90 .0% . Conclusion Gram‐negative bacteria is the predominant pathogen infecting patients in neurosurgery ,w hile Staphylococcus aureus are the most common isolates .For the increase of multiple drug‐resistant and pan‐drug‐resistant bacteria ,clinical rational use of antibac‐terial agents for anti‐infection treatment may be very important .
出处
《国际检验医学杂志》
CAS
2015年第18期2617-2619,共3页
International Journal of Laboratory Medicine
基金
国家自然科学基金项目(81000767)
关键词
神经外科
病原菌分布
药物敏感性
neurosurgery
pathogen distribution
drug susceptibility
