摘要
目的了解我国中枢神经系统感染患者细菌的构成及耐药性,为临床使用抗菌药物提供依据。方法采用纸片法、MIC法或E-test法测定细菌药物敏感性,使用WHONET5.6软件进行分析,对卫生部全国细菌耐药性监测网(Mohnarin)成员医院2011年1月1日-12月31日分离的脑脊液标本菌株进行分析。结果共有49所医院从脑脊液标本分离出细菌742株,其中革兰阳性菌483株占65.1%,革兰阴性菌259株占34.9%;最常见的革兰阳性菌依次为凝固酶阴性葡萄球菌329株、金黄色葡萄球菌50株、肠球菌属47株和链球菌属40株,分别占44.3%、6.7%、6.3%、5.4%;最常见的革兰阴性菌依次为不动杆菌属99株、铜绿假单胞菌30株、克雷伯菌属30株和大肠埃希菌27株,分别占13.3%、4.0%、3.6%、3.6%;耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌的检出率分别为61.3%和68.7%,未发现耐万古霉素金黄色葡萄球菌,检测到1株耐万古霉素屎肠球菌;大肠埃希菌和肺炎克雷伯菌中产ESBLs的检出率分别为53.3%和94.7%。结论我国中枢神经系统感染在外科组不动杆菌属所占比例明显高于内科组;脑脊液来源的MRSA发生率较高,并检测到碳青霉烯类抗菌药物耐药肠杆菌科细菌。
OBJECTIVE To explore the distribution and resistance of bacteria isolated from cerebrospinal fluid so as to provide basis for the clinical use of antibiotics.METHODS The disc diffusion test,MIC test and E-test were used to detect the antimicrobial sensitivity of bacterial isolates.WHONET 5.6 was applied for analyzing the bacterial sensitive data from Mohnarin member hospitals in China from Jan 1 to Dec 30 2011.RESULTS A total of 742 strains of bacteria were isolated from cerebral spinal fluid in 49 hospitals,including 483（65.1%） strains of gram-positive bacteria and 259（34.9%） strains of gram-negative bacteria.Coagulase-negative Staphylococci（329 strains）,Staphylococcus aureus（50 strains）,Enterococcus spp（47 strains）,and Streptococcus spp（40 stains） were the most common gram-positive bacteria,accounting for 44.3%,6.7%,6.3%,and 5.4%,respectively.while Acinetobacter spp.（99 strains）,Pseudomonas aeruginosa（30 stains）,Klebsiella spp.（30 strains）,and Escherichia coli（27 strains） were the most common gram-negative bacteria,accounting for 13.3%,4.0%,6%,and 3.6%,respectively.The detection rates of the metihcillin-resistant S.aureus and coagulase-negative Staphylococci were 61.3% and 68.7%,respectively.Vancomycin-resistant S.aureus was not detected.One strain of vancomycin-resistant E.faecium was detected.The ESBLs producing rates of E.coli and K.pneumoniae were 53.3% and 94.7%,respectively.CONCLUSION The isolation rate of Acinetobacter spp.from neurosurgical patients is significantly higher than that of the strains from medical patients.The incidence of MRSA is high in the cerebrospinal fluid,and the carbapenems-resistant Enterobacteriaceae are detected in cerebrospinal fluid.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第24期5493-5496,5502,共5页
Chinese Journal of Nosocomiology
基金
卫生行业科研专项项目(2010021021)
