开颅术后或头颅外伤后颅内感染病原学检测及临床治疗

摘要

Objective:To provide the basis for the clinical treatment,researchers used the pathogen test and the drug-susceptibility test in patients with intracranial infection after Craniotomy or head trauma.Method:Cerebrospinal fluid from 55 patients with intracranial infection after craniotomy or head trauma, who had been in the hospitals from January 2008 to Jan 2013,were examined.Bacterial aerobic culture and drug-susceptibility test were performed by using the automatic bacterial analysis system.Result:A total of 110 copies of cerebrospinal fluid achieved by 55 patients,51 cases were positive(46.36%),46 pathogens were isolated,33 cases was Gram-positive bacteria (71.74%),12 cases was Gram-negative bacteria(26.09%),one case was fungi(2.17%).The top five pathogen were coagulase-negative staphylococci in 25 cases(54.35%),Staphylococcus aureus in 5 cases(10.86%),Enterobacter in 3 cases(6.52%),Acinetobacter in 3 cases(6.52%),Pseudomonas aeruginosa in 2 cases(4.35%).Fivty-five cases were efficient significantly in 55 patients,2 patients were discharged,and 2 patients were dead(3.63%).Conclusion:Detecting pathogens timely,diagnosing early and giving antibiotics efficient and sensitive by the combination of intravenous and intrathecal can improve the cure rate and shorten the course of treatment effectively.%目的：：对开颅术后或外伤后颅内感染患者进行病原学检测及药敏分析，为临床合理治疗提供依据。方法：收集2008年1月-2013年1月共55例开颅术后或外伤后怀疑有颅内感染患者，取脑脊液进行病原体检测，同时做药敏试验。细菌培养采用全自动微生物分析系统Phoenix 100进行菌种鉴定。采用静脉联合鞘内给予敏感药物治疗颅内感染患者。结果：55例患者共取得110份脑脊液进行细菌培养，阳性51例，阳性率46.36%，分离培养出致病菌46株，其中革兰阳性菌33株(71.74%)，革兰阴性菌12株(26.09%)，真菌1株(2.17%)。排名前5位的致病菌分别为凝固酶阴性葡萄球菌25株(54.35%)、金黄色葡萄球菌5株(10.87%)、肠杆菌属3株(6.52%)、不动杆菌3株(6.52%)、铜绿假单胞菌2株(4.35%)。55例患者中，51例效果明显，2例自动出院，2例死亡(3.63%)。结论：及时进行病原学检测和诊断，尽早静脉联合鞘内给予高效、敏感的抗菌药物，能有效提高治愈率，缩短疗程。