摘要
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 antimicrobial resistance spectrum of pathogens from 937 cerebrospinal fluid specimens,so as to provide basis for the clinical diagnosis and rational use of antibiotics. Methods The identification and antimicrobial susceptibility test of pathogen were carried out by VITEK full automated microbiology analyzer. Results 153 strains were isolated from 973 cerebrospinal fluid specimens,with the positive rate of 15. 7%. Coagulase-negative Staphylococcus（ 32. 7%）,Acinetobacter baumanii（ 15. 0%）,Enterococcus isolates（ 11. 1%）,Crytococcus neofonmans（ 10. 5%） and Klebsiella pneumoniae（ 9. 8%） were the top 5 isolated pathogens. Staphylococcus aureus were 100. 0% resistant to penicillin G. The resistance rates to erythromycin,oxacillin and clindamycin were as high as 80. 0%. The drug resistance rates of the coagulase-negative Staphylococcus to penicillin G,erythromycin,penicillin reached 70. 0%. The resistance rate of Enterococcus faecium to erythromycin,moxifloxacin,levofloxacin was as high as 70. 0%. The resistance rates of Bauman acinetobacter to imipenem and ertapenem were respectively 54. 5% and 100. 0%. And the resistance rate of Klebsiella pneumoniae to ciprofloxacin,ceftriaxone,ampicillin / sulbactam was more than 60%. Conclusion The prevailing pathogens in cerebrospinal fluid specimens are mainly gram-positive isolates,and Acinetobacter baumanii ranks the first place of the gram-negative isolates. A new type of Streptococcus takes a certain proportion of it. This study provides reliable data for the prevention and empirical antimicrobial therapy of central nervous system infection.
出处
《中国卫生检验杂志》
CAS
2016年第19期2871-2873,2876,共4页
Chinese Journal of Health Laboratory Technology
基金
浙江省科技创新团队项目(2011R50018-11)
关键词
脑脊液
病原菌
耐药
Cerebrospinal fluid
Pathogens
Drug resistance
