CAJ | 학술논문

目的监测脑外伤术后患者脑脊液致病菌流行病学分布及耐药状况.方法收集我院神经外科2003年1月-2007年12月送检的682例脑脊液标本中分离的致病菌及药敏鉴定结果,统计致病菌分布和抗菌药物敏感率.结果分离到致病菌437株,其中革兰阳性球菌321株,占73.5%;革兰阴性杆菌116株,占26.5%;排名前5位的致病菌分别为凝固酶阴性葡萄球菌(55.6%)、金黄色葡萄球菌(15.3%)、肠杆菌属(6.6%)、不动杆菌(5.3%)、铜绿假单胞菌(3.0%).对革兰阴性菌的总体敏感率:亚胺培南83.9%,哌拉西林/他唑巴坦67.4%,阿米卡星68.8%,头孢吡肟61.3%,头孢他啶69.2%,其余抗菌药物的敏感率均<60%.结论脑外伤患者颅内感染以革兰阳性菌多见,尤其是凝固酶阴性葡萄球菌和金黄色葡萄球菌.本研究结果将为脑外伤术后颅内感染的预防和经验性抗菌药物治疗提供基本依据.
목적 감측뇌외상술후환자뇌척액치병균류행병학분포급내약상황.방법 수집아원신경외과2003년1월-2007년12월송검적682례뇌척액표본중분리적치병균급약민감정결과,통계치병균분포화항균약물민감솔.결과 분리도치병균437주,기중혁란양성구균321주,점73.5%;혁란음성간균116주,점26.5%;배명전5위적치병균분별위응고매음성포도구균(55.6%)、금황색포도구균(15.3%)、장간균속(6.6%)、불동간균(5.3%)、동록가단포균(3.0%).대혁란음성균적총체민감솔:아알배남83.9%,고랍서림/타서파탄67.4%,아미잡성68.8%,두포필우61.3%,두포타정69.2%,기여항균약물적민감솔균<60%.결론 뇌외상환자로내감염이혁란양성균다견,우기시응고매음성포도구균화금황색포도구균.본연구결과장위뇌외상술후로내감염적예방화경험성항균약물치료제공기본의거.
Objective To monitor epidemiological distribution and antibiotic resistance of bacteria isolated from cerebral spinal fluid in neurosurgically treated patients. Methods Bacteria isolated from cerebral spinal fluid specimens and antibiotic resistance identification results of patients admitted into our department from January 2003 to December 2007 were collected to analyze distribution and antibiotic resistance of the pathogens. Results Of 437 isolates, Gram-positive bacilli and Gram-negative bacilli accounted for 73.5% (321 isolates) and 26.5% ( 116 isolates), respectively. The first five most fre-quently isolated pathogens were staphylococcus epidermidis (55.6%), staphylococcus aurens (15. 3% ), enterobacter (6.6%), aeinetobacter (5.3%) and pseudomonas aeruginosa (3.0%). The anti-bacterials with highest susceptibility to Gram-negative bacilli were imipenem ( 83.9% ), amikacin ( 68. 8% ), ciprofloxacin and tobramycin (67.4%), cefepime (61.3%) and ceftazidime (69.2%). The other antibacterials had susceptibility of less than 60%. Conclusions The prevailing pathogens in post-operative intracranial infection are Gram-pnsitive bacilli, especially staphylococcus epidermidis and staphylococcus anreu. Data collected in present study may provide valuable information for prophylactic and empirical antibiotic use in post-operative intracranial infection.