开颅术后中枢神经系统感染患者细菌分布特点及抗菌药物敏感性分析OACSTPCD

Objective To analyze the bacterial distribution and antibiotic sensitivity of central nervous system infection after craniotomy.Methods The data of 121 patients with postoperative central nervous system infection who underwent craniotomy in Beijing Tiantan Hospital,Capital Medical from January 2017 to December 2021 were retrospectively analyzed.The pathogenic bacteria species and drug sensitivity test results of cerebrospinal fluid infection in all patients were summarized and analyzed.Results A total of 129 pathogenic strains were isolated from the cerebrospinal fluid of 115 patients,including 88 strains of Gram-positive bacteria and 41 strains of Gram-negative bacteria.The highest proportion of Staphylococcus epidermidis in Gram-positive bacteria was 27.30%,and the highest proportion of Klebsiella pneumoniae in Gram-negative bacteria was 34.15%.Among Gram-positive bacteria,vancomycin,linezolid,teicoplanin,furazoline,quinuptin/dafopltin and vancomycin had the highest sensitivity to coagulase negative Staphylococcus and Staphylococcus aureus,and oxacillin had the highest sensitivity to Enterococcus and Streptococcus.Among Gram-negative bacteria,the highest sensitivity rate of compound sulfadiazine to Klebsiella was 77.78%,the highest sensitivity rate of polymyxin to Acinetobacter was 100%,and the highest sensitivity rate of amikacin and cefepime to Enterobacter was 100%.The susceptibility rate of amikacin,meropenem,piperacillin/tazobactam,cefepime and ceftazidime to other bacteria was 60.00%.Conclusion Postoperative infection in patients with central nervous system to craniotomy coagulase negative staphylococcus aureus,klebsiella bacteria genera,enterococcus,acinetobacter,staphylococcus aureus is more common.Through our data in combination with other research progress at home and abroad,in the clinical commonly used antimicrobial agents to meropenem,vancomycin,as the preferred experience administration for drug-resistant bacteria,the need for joint linezolid,tigecycline,polymyxin,amikacin,gentamicin,etc.Necessary need intravenous drug combined intrathecal injection as the basic strategy.We also suggest the reasonable control of the duration of antibiotics at the same period,and then according to the following specific bacterial culture and drug susceptibility characteristics optimization scheme.