论文部分内容阅读
目的了解鲍曼不动杆菌(Acinetobacter baumannii,Aba)引起颅内感染耐药性特点及感染的危险因素,为指导临床合理选用抗菌药物及感染控制提供依据。方法回顾性分析2012-10/2015-10月作者医院神经外科颅内感染患者送检的脑脊液标本的临床及微生物资料,采用SPSS 19.0软件分析病原菌分布和Aba药敏结果以及Aba引起颅内感染的危险因素。结果在74株颅内感染的脑脊液标本中,分离到Aba 43株,其他病原菌31株,Aba占58.1%,该菌除对替加环素保持较高的敏感性外,对大多数抗菌药物的敏感性最高仅到20%。非多重耐药性Aba为5株(占11.6%),多重耐药Aba为16株(占37.2%),泛耐药Aba为22株(占51.2%)。患者发生肺炎、气管切开、气管插管、经外周静脉穿刺中心静脉置管术(peripherally inserted central catheter,PICC)置管及鼻饲是发生Aba颅内感染的危险因素。结论 Aba是引起颅脑手术患者颅内感染的最常见病原菌,且面临严峻的耐药形势,因此需要针对肺炎、气管切开、气管插管、PICC置管及鼻饲等危险因素制定有效的感染控制措施,减少Aba引起的颅内感染。
Objective To understand the characteristics of drug-resistant intracranial infection caused by Acinetobacter baumannii (Aba) and the risk factors of infection in order to provide a basis for clinical rational use of antimicrobial agents and infection control. Methods The clinical and microbiological data of cerebrospinal fluid from patients with intracranial infection in neurosurgery from 2012 to October 2015 to October were retrospectively analyzed. The distribution of pathogens and the drug sensitivity of Aba were analyzed by SPSS 19.0 software and the intracranial infection caused by Aba Risk factors. Results Among the 74 CSF samples, 43 strains of Aba were isolated and 31 of the other pathogenic bacteria were Abs, accounting for 58.1% of the total. Among the 96 bacterial strains, the strain maintained high sensitivity to tigecycline, Sensitivity up to only 20%. There were 5 non-multi-drug Aba strains (11.6%), 16 multi-drug resistant Aba strains (37.2%) and pan-drug resistant Aba (22.2%). Patients with pneumonia, tracheotomy, tracheal intubation, peripherally inserted central catheter (peripherally inserted central catheter, PICC) catheterization and nasal feeding are risk factors for Aba intracranial infection. Conclusions Aba is the most common pathogen causing intracranial infection in patients with craniocerebral surgery and faces severe drug resistance. Therefore, effective infection control should be developed for risk factors such as pneumonia, tracheostomy, endotracheal intubation, PICC catheterization and nasal feeding Measures to reduce Aba caused by intracranial infection.