目的:分析内蒙古包头地区脑脊液感染的病原菌分布情况和耐药性趋势。方法:收集包头市三甲医院2013-2024年244例脑脊液培养阳性患者的临床资料,对样本进行分离、菌种鉴定和药敏试验,比较不同病原菌感染的生化指标差异。结果:脑脊液培养阳性菌中,革兰氏阳性菌、革兰氏阴性菌、真菌占比分别为65.2%,33.2%和1.6%。流行病学研究表明,病原菌分布在不同季节存在显著性差异(P＜0.05),夏季常见表皮葡萄球菌(16.7%),秋季常见头状葡萄球菌(13.4%)、鲍曼不动杆菌(11.9%),冬季则以金黄色葡萄球菌(10.3%)和肺炎克雷伯菌(8.6%)较为常见;在年龄分布中无显著性差异,但肺炎链球菌在≤12岁年龄组中数量较多、鲍曼不动菌在≥60岁年龄组占比最高。药敏结果显示,葡萄球菌属菌株对利奈唑胺、万古霉素无耐药性;肺炎链球菌对氧氟沙星、替考拉宁无耐药性;鲍曼不动杆菌对头孢哌酮/舒巴担无耐药性;碳青霉烯类药物在大肠埃希菌属的治疗上效果较好;肺炎克雷伯菌属对亚胺培南、美洛培南较敏感。结论:2013-2024年脑脊液感染中主要以表皮葡萄球菌较为常见。此外,病原菌在不同季节中的显著性差异可为疾病预防和改进循证治疗提供有价值的策略。
Objective: To analyze the distribution and drug resistance of pathogenic bacteria in cerebrospinal fluid infection in Baotou area of Inner Mongolia. Methods: The clinical data of 244 patients with positive cerebrospinal fluid culture from 2013 to 2024 in our hospital were collected. The samples were isolated, identified and tested for drug sensitivity, and the biochemical indexes of different pathogenic bacteria were compared. Results: Among the positive bacteria in cerebrospinal fluid culture, Gram-positive bacteria, Gram-negative bacteria and fungi accounted for 65.2%, 33.2% and 1.6%, respectively. Epidemiological studies showed that there were significant differences in the distribution of pathogens in different seasons (P＜0.05), while Staphylococcus epidermidis (16.7%) was common in summer, Staphylococcus capitis (13.4%) and Acinetobacter baumannii (11.9%) were common in autumn, and Staphylococcus aureus (10.3%) and Klebsiella pneumoniae (8.6%) were common in winter. There was no significant difference in the age distribution of pathogenic bacteria, but the content of Streptococcus pneumoniae was the higher in the age group of ≤12 years old, and the proportion of Acinetobacter baumannii was the highest in the age group of ≥60 years old. The results of drug sensitivity showed that Staphylococcus strains had no resistance to linezolid and vancomycin. Streptococcus pneumoniae had no resistance to ofloxacin and teicoplanin. Acinetobacter baumannii had no resistance to cefoperazone/sulbactam; the effect of carbapenem in the treatment of Escherichia coli was better; Klebsiella pneumoniae was sensitive to imipenem and meropenem. Conclusion: Staphylococeus epidermidis are more common in cerebrospinal fluid infections from 2013 to 2024. In addition, the significant differences in pathogens in different seasons can provide valuable strategies for disease prevention and improvement of evidence-based treatment.
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