“ESKAPE”在神经外科医源性感染的流行病学研究

doi:10.3969/j.issn.1006-7795.2017.04.009

首都医科大学学报 ›› 2017, Vol. 38 ›› Issue (4): 530-534.doi: 10.3969/j.issn.1006-7795.2017.04.009

“ESKAPE”在神经外科医源性感染的流行病学研究

刘竞争, 郑光辉, 吕虹, 陈燕, 马瑞敏, 张国军

首都医科大学附属北京天坛医院检验科, 北京 100050

收稿日期:2017-05-09 出版日期:2017-07-21 发布日期:2017-07-20
通讯作者: 张国军 E-mail:tiantanzgj@163.com
基金资助:
北京市卫生系统高层次卫生技术人才培养计划项目（2013-3-052），北京市优秀人才青年拔尖个人项目（2015000021223ZK34）

Epidemiological study of “ESKAPE” infections in neurosurgery wards

Liu Jingzheng, Zheng Guanghui, Lyu Hong, Chen Yan, Ma Ruimin, Zhang Guojun

Department of Clinical Laboratory, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China

Received:2017-05-09 Online:2017-07-21 Published:2017-07-20
Supported by:
This study was supported by Beijing High Quality Health Technology System Personnel Training Program(2013-3-052), Beijing Outstanding Talent Young Top-notch Personal Projects(2015000021223ZK34)

摘要/Abstract

摘要： 目的探索2012－2016年6类严重耐药菌在神经外科医源性感染病人的流行病学研究。方法收集2012年1月至2016年12月首都医科大学附属北京天坛医院神经外科术后病人脑脊液培养阳性的6类耐药菌并分析其分类与耐药问题。结果 5年来，脑脊液培养阳性分离株共2 250株。其中6类致病菌共523株，占23.2%，肺炎克雷伯菌、鲍曼不动杆菌与金黄色葡萄球菌的分离率高于屎肠球菌、铜绿假单胞菌与肠杆菌属。2012－2016年神经外科医源性感染金黄色葡萄球菌方面，耐甲氧西林金黄色葡萄球菌（methicillin-resistant Staphylococcus aureus，MRSA）的构成比高达49%，肺炎克雷伯菌与鲍曼不动杆菌的碳青霉烯耐药率也高于40.0%。结论 2012－2016年间，6类常见院内感染致病菌在神经系统医源性感染方面耐药较为严重，尤其是MRSA、万古霉素耐药肠杆菌（vancomycin resistant Enterobacteriaceae，VRE）、碳青霉烯耐药肠杆菌（carbapenem resistant Enterobacteriaceae，CRE）等耐药菌的泛滥，使得临床上选择抗生素对神经外科医源性感染的疗效不容乐观。

关键词: 耐药菌, 神经外科术后感染, 脑脊液

Abstract: Objective To explore the epidemiological features of six kinds of severe drug-resistant bacteria in patients with neurosurgery-induced infection in 2012-2016.Methods Six kinds of antibiotic resistant bacteria isolated from cerebrospinal fluid in patients with neurosurgery were collected from January 2012 to December 2016 in Beijing Tiantan Hospital Affiliated to Capital Medical University, and their epidemiological characteristics and drug resistance were analyzed. Results In the past 5 years, 2 250 isolates of pathogens in cerebrospinal fluid culture were isolated. Among them, the separation rate of six strains of pathogenic bacteria is 23.2%, accounting forKlebsiella pneumoniae, Acinetobacter baumannii and Staphylococcus aureus was higher than that of Enterococcus faecalis, Pseudomonas aeruginosa and Enterobacter spp. The resistance rate of MRSA was higher than 40.0%, and the resistance rate of carbapenem to Klebsiella pneumoniae and Acinetobacter baumannii was higher than 40.0%. Conclusion In the period of 2012-2016, six kinds of common nosocomial infection pathogens were more resistant to iatrogenic infection in the neurosurgical patients, especially the proliferation of drug-resistant bacteria such as methicillin-resistant Staphylococcus aureus(MRSA), vancomycin resistant Enterobacteriaceae (VRE) and (carbapenem resistant Enterobacteriaceae (CRE), and the clinical selection of antibiotics for neurosurgery. The ESKAPE infection in neurosurgery ward is bad.

Key words: drug-resistance bacteria, neurosurgical infection, cerebrospinal fluid

中图分类号:

R446.6

刘竞争, 郑光辉, 吕虹, 陈燕, 马瑞敏, 张国军. “ESKAPE”在神经外科医源性感染的流行病学研究[J]. 首都医科大学学报, 2017, 38(4): 530-534.

Liu Jingzheng, Zheng Guanghui, Lyu Hong, Chen Yan, Ma Ruimin, Zhang Guojun. Epidemiological study of “ESKAPE” infections in neurosurgery wards[J]. Journal of Capital Medical University, 2017, 38(4): 530-534.

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“ESKAPE”在神经外科医源性感染的流行病学研究

Epidemiological study of “ESKAPE” infections in neurosurgery wards

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