摘要
目的了解中枢神经系统感染常见病原菌的临床分布及其对常用抗菌药物的耐药性,为临床合理选用抗菌药物提供参考依据。方法回顾分析2012—2016年脑脊液标本中分离的病原菌,采用纸片扩散法进行药物敏感性试验[新型隐球菌采用ATB板条测定最低抑菌浓度(MIC)值]。结果从脑脊液标本中共分离病原菌643株,前5位病原菌分别为表皮葡萄球菌101株(15.7%)、鲍曼不动杆菌59株(9.2%)、金黄色葡萄球菌52株(8.1%)、新型隐球菌49株(7.6%)和溶血葡萄球菌40株(6.2%)。药敏试验结果显示,鲍曼不动杆菌对常用抗菌药物的敏感率均<25%,金黄色葡萄球菌对复方磺胺甲唑、万古霉素、替考拉宁和利奈唑胺的敏感率均>98%,新型隐球菌对氟康唑、两性霉素、氟胞嘧啶和伏立康唑的敏感率均>95%。结论该院中枢神经系统感染分离的病原菌以鲍曼不动杆菌、金黄色葡萄球菌和新型隐球菌为主,鲍曼不动杆菌耐药现象严重,临床医师应根据药敏结果合理选用抗菌药物。
Objective To investigate the clinical distribution and drug resistance of common pathogenic bacteria in central nervous system infection and provide reference for rational use of antibiotics in clinic. Methods Retrospective analysis of pathogenic bacteria isolated from cerebrospinal fluid specimens in our hospital from 2012 to 2016 was carried out. Drug susceptibility was tested by K-B method except for Cryptococcus neoformans by the ATB method of MIC value. Results A total of 643 strains of pathogenic bacteria were isolated from cerebrospinal fluid specimens,and the top five pathogens were as following： 101 batches were Staphylococcus epidermidis（15.7%）,59 batches were Acinetobacter Bauman（9.2%）,52 batches were Staphylococcus aureus（8. 1%）,49 batches were Cryptococcus neoformans（7. 6%） and 40 batches were Staphylococcus haemolyticus（6.2%）. The results of drug sensitivity showed that the sensitivity of Acinetobacter baumannii to common antibiotics was less than 25%,the sensitive rate of Staphylococcus aureus to cotrimoxazole,vancomycin,teicoplanin and linezolid were more than 98%,the sensitive rate of fluconazole,amphotericin,5-fluorine cytosineand voriconazole to Cryptococcus neoformans was more than 95%. Conclusion The main pathogenic bacterias isolated from the central nervous system infection in hospital were Acinetobacter Bauman,Staphylococcus aureus and Cryptococcus neoformans. Drug resistance was serious for Acinetobacter Bauman.Clinicians should select antibiotics according to the results of drug sensitivity.
作者
田磊
张真
陈中举
孙自镛
TIAN Lei;ZHANG Zhen;CHEN Zhongju;SUN Ziyong(Department of Clinical Laboratory;Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China)
出处
《医药导报》
CAS
北大核心
2018年第6期741-744,共4页
Herald of Medicine
基金
"艾滋病和病毒性肝炎等重大传染病防治"科技重大专项课题(2017ZX10103005-007)
关键词
抗菌药物
感染
中枢神经系统
脑脊液
鲍曼不动杆菌
新型隐球菌
Antibactefials
Intection
central nervous system
Cerebrospinal fluid
Acirwtobacter Bauman
Cryptococcus neoformans
