【摘要】：目的:主要探討鼻源性顱內(nèi)感染的細(xì)菌學(xué)分布和藥敏特征,及其與慢性鼻竇炎患者的細(xì)菌性分布之間的關(guān)系,為臨床上早期經(jīng)驗性選擇抗生素提供參考。方法:收集2009年1月—2017年1月我院神經(jīng)外科鼻源性顱內(nèi)感染膿液或腦脊液細(xì)菌培養(yǎng)陽性患者數(shù)據(jù),同步收集2016年4月—2017年1月我院耳鼻喉科慢性鼻竇炎患者鼻及鼻竇拭子細(xì)菌培養(yǎng)陽性數(shù)據(jù),分析兩組數(shù)據(jù)細(xì)菌學(xué)分布特點和藥敏特征。結(jié)果:5例鼻源性顱內(nèi)感染患者培養(yǎng)出致病菌5株,其中G+菌有4株,分別是糞腸球菌、草綠色鏈球菌、棒狀桿菌、凝固酶陰性葡萄球菌(MRSCON+),G-菌1株,為肺炎克雷伯桿菌;42例慢性鼻竇炎致病菌57株,其中15例患者是兩種細(xì)菌的混合感染,G+菌有49株,其中葡萄球菌29株,G-菌有8株。兩組患者細(xì)菌學(xué)分布具有相關(guān)性,G+對萬古霉素和利奈唑胺高度敏感,且對紅霉素都有較高的耐藥率。結(jié)論:通過回顧性分析兩組疾病細(xì)菌培養(yǎng)數(shù)據(jù),得出以下結(jié)論:1.G+菌是鼻源性顱內(nèi)感染和慢性鼻竇炎主要致病菌,G-菌也占有一定的比例,經(jīng)驗性治療時應(yīng)該兩種細(xì)菌并重。2.兩組疾病對萬古霉素和利奈唑胺高度敏感,且對紅霉素都有較高的耐藥率,經(jīng)驗性用藥時要綜合考慮藥物敏感性和耐藥性。3.鼻源性顱內(nèi)感染和慢性鼻竇炎常見致病菌種類分布上有一致性,革蘭陽性菌和陰性菌構(gòu)成比無統(tǒng)計學(xué)差異。
[Abstract]:Objective: to investigate the bacteriological distribution and drug sensitivity of rhinogenic intracranial infection and its relationship with bacterial distribution in patients with chronic sinusitis, so as to provide a reference for clinical experience in the selection of antibiotics. Methods: data were collected from January 2009 to January 2017 in patients with sepsis or cerebrospinal fluid culture positive from neurosurgery nasogenic intracranial infection in our hospital. The bacterial culture positive data of nasal and nasal swabs in patients with chronic sinusitis in our hospital from April 2016 to January 2017 were collected simultaneously. The bacteriological distribution and drug sensitivity of the two groups were analyzed. Results: five strains of pathogenic bacteria were isolated from 5 patients with rhinogenic intracranial infection. Among them, 4 strains were Enterococcus faecalis, streptococcus grass green, 1 strain of Corynebacterium and 1 strain of (MRSCON), G- bacteria of coagulase-negative staphylococcus. Klebsiella pneumoniae; There were 57 strains of pathogenic bacteria in 42 cases of chronic sinusitis, of which 15 cases were mixed infection of two kinds of bacteria. There were 49 strains of G bacteria, including 29 strains of staphylococcus and 8 strains of G- bacteria. G was highly sensitive to vancomycin and linazolamide and had high resistance to erythromycin. Conclusion: through the retrospective analysis of the bacterial culture data of the two groups of diseases, the following conclusions can be drawn: 1. G bacteria are the main pathogens of rhinogenic intracranial infection and chronic sinusitis, and G- bacteria also account for a certain proportion. Empirical therapy should be given equal weight to both bacteria. 2. 2. The two groups were highly sensitive to vancomycin and linazolamide and had high resistance to erythromycin. The distribution of common pathogenic bacteria in rhinogenic intracranial infection and chronic sinusitis was consistent, but there was no statistical difference between Gram-positive bacteria and negative bacteria.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R446.5;R742.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 茍立華;胡韞科;白成祥;;慢性鼻竇炎患者鼻腔(膿性)分泌物的細(xì)菌譜及其藥敏分析[J];川北醫(yī)學(xué)院學(xué)報;2015年06期

2 陳貞君;傅祥湞;李華;;利奈唑胺與萬古霉素治療顱內(nèi)感染的療效對比觀察[J];西南國防醫(yī)藥;2015年10期

3 李建明;張誠;;CT引導(dǎo)下微創(chuàng)穿刺聯(lián)合持續(xù)沖洗引流治療腦膿腫的療效研究[J];醫(yī)學(xué)綜述;2015年15期

4 王士杰;王好真;馬玉茹;劉秀平;于淑蘭;;慢性鼻-鼻竇炎的細(xì)菌培養(yǎng)與藥敏分析[J];中國耳鼻咽喉頭頸外科;2015年06期

5 何金超;夏成雨;傅先明;;腦膿腫的影像學(xué)診斷和治療進(jìn)展[J];山東醫(yī)藥;2015年13期

6 張元寶;;萬古霉素在治療顱內(nèi)感染的臨床分析[J];海峽藥學(xué);2015年02期

7 宋志軍;陳曉雷;唐運林;唐博恒;曾婷;孫正輝;余新光;周定標(biāo);;應(yīng)用磁共振波譜診斷及術(shù)中磁共振導(dǎo)航對腦膿腫的穿刺引流治療[J];中華醫(yī)學(xué)雜志;2014年25期

8 于煥新;劉鋼;;鼻源性腦膿腫的臨床分析[J];中華耳鼻咽喉頭頸外科雜志;2014年03期

9 譚鑫;曾火勇;沈曉丹;勞佳;;神經(jīng)外科患者腦脊液感染的細(xì)菌流行病學(xué)分布和耐藥性監(jiān)測[J];中國現(xiàn)代醫(yī)生;2014年03期

10 瞿亞紅;陳麗娜;熊逸群;;慢性鼻竇炎患者鼻腔菌群分布及耐藥性分析[J];現(xiàn)代實用醫(yī)學(xué);2013年09期

相關(guān)會議論文 前1條

1 王紅鑫;;腦膿腫的最新治療進(jìn)展及其最佳治療策略[A];2011中華醫(yī)學(xué)會神經(jīng)外科學(xué)學(xué)術(shù)會議論文匯編[C];2011年

，

本文編號：2423640