【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

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