本文關(guān)鍵詞： 腦膠質(zhì)瘤手術(shù) 顱內(nèi)感染 病原菌 危險(xiǎn)因素　出處：《中華醫(yī)院感染學(xué)雜志》2017年20期 　論文類型：期刊論文

【摘要】：目的探討腦膠質(zhì)瘤手術(shù)后顱內(nèi)感染病原菌特點(diǎn)及危險(xiǎn)因素。方法選取醫(yī)院2008年1月-2016年12月收治的腦膠質(zhì)瘤手術(shù)患者94例,回顧性分析顱內(nèi)感染患者腦脊液培養(yǎng)病原菌分布和其對抗菌藥物的耐藥性及發(fā)生感染的危險(xiǎn)因素。結(jié)果 94例腦膠質(zhì)瘤手術(shù)患者術(shù)后顱內(nèi)感染患者13例,感染率為13.83%;共分離培養(yǎng)病原菌36株,其中革蘭陽性菌22例占61.11%,革蘭陰性菌14例占38.89%;革蘭陽性菌中金黃色葡萄球菌對紅霉素、青霉素、四環(huán)素耐藥率較高,分別為100.00%、90.00%、70.00%;表皮葡萄球菌對青霉素、四環(huán)素、紅霉素耐藥率較高,分別為100.00%、87.50%、75.00%;革蘭陰性菌中肺炎克雷伯菌對頭孢呋辛、氨芐西林耐藥率較高,均為83.33%;鮑氏不動(dòng)桿菌對氨芐西林、頭孢呋辛耐藥率較高,分別為100.00%、80.00%。年齡、手術(shù)時(shí)間、預(yù)防性抗菌藥物為術(shù)后顱內(nèi)感染的獨(dú)立危險(xiǎn)因素(P0.05)。結(jié)論腦膠質(zhì)瘤手術(shù)患者術(shù)后顱內(nèi)感染病原菌以革蘭陽性菌居多,應(yīng)根據(jù)藥敏結(jié)果合理使用抗菌藥物,并注意感染危險(xiǎn)因素以降低感染率。
[Abstract]:Objective to investigate the pathogenic bacteria characteristics and risk factors of intracranial infection after glioma surgery. Methods 94 patients with glioma were selected from January 2008 to December 2016 in our hospital. The distribution of pathogenic bacteria in cerebrospinal fluid culture of patients with intracranial infection, the drug resistance to antibiotics and the risk factors of infection were analyzed retrospectively. Results there were 13 cases of intracranial infection after operation in 94 patients with glioma. The infection rate was 13.83%, 36 strains of pathogenic bacteria were isolated and cultured, of which 22 cases were Gram-positive bacteria (61.11%), 14 cases Gram-negative bacteria (38.89%), and the rate of resistance of Staphylococcus aureus to erythromycin, penicillin and tetracycline was higher in Gram-positive bacteria. The resistance rates of Staphylococcus epidermidis to penicillin, tetracycline and erythromycin were 100.00,87.50g and 75.00, respectively. Klebsiella pneumoniae showed higher resistance to cefuroxime and ampicillin in Gram-negative bacteria, all of which were 83.33; Acinetobacter baumannii was resistant to ampicillin. The drug resistance rate of cefuroxime was 100.0080.00.Age, operation time, prophylactic antibiotics were the independent risk factors of intracranial infection after operation (P 0.05). Conclusion Gram-positive bacteria are the main pathogens of intracranial infection in patients with glioma after operation. Antibiotics should be used rationally according to drug sensitivity and risk factors of infection should be paid attention to to reduce infection rate.
【作者單位】： 寧波市醫(yī)療中心李惠利東部醫(yī)院神經(jīng)外科;
【基金】：寧波市自然基金資助項(xiàng)目(2012A610195)
【分類號】：R739.41

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