Abstract: Objective By reviewing the pathogenic bacteria results of hospital-acquired infections from inpatients in our neurosurgery department, we analyzed their distribution characteristics and drug resistance in order to provide more supportive ideas for clinical infection prevention, diagnosis and treatments. Methods The pathogenic bacteria of 738 hospital-acquired infections from 639 inpatients in neurosurgery department from June, 2016 to June, 2019 were collected. We used statistical methods to analyze the characteristics and drug resistance of these pathogens. Results There were 738 hospital-acquired infectious cases, including hospital-acquired pneumonia （377 cases）, urinary system infections （130 cases）, bloodstream infections （109 cases）, central nervous system infections （106 cases）, and other infections （16 cases）. Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus are the main pathogens. In the clinical use of important antibacterial drugs, Escherichia coli and Klebsiella pneumoniae showed high rates of drug resistance to ceftriaxone （62.1% and 56.25%）. And their resistance rates to imipenem were 2.01% and 16.4% respectively. Pseudomonas aeruginosa was below 30%. Acinetobacter baumannii was beyond 50% （except for minocycline）. Staphylococcus aureus was 61.29%, and Coagulase-negative Staphylococci was 79.23%. Staphylococcus was not found to be resistant to vancomycin, linezolid and tigecycline. The resistance rate of Candida was below 10%. Conclusion Hospital-acquired infections of inpatients in neurosurgery department are mainly Gram-negative bacteria and Staphylococcus, and we also found the drug resistance is extremely serious. In clinical daily diagnosis and treatments, we suggest antibiotics be used rationally according to the characteristics of pathogens and the drug resistance situations monitoring in this hospital.

Key words: neurosurgery, hospital acquired infection, pathogen, drug resistance

摘要： 目的 回顾我院神经外科住院患者医院获得性感染病原菌结果,分析医院获得性感染病原菌分布特点及耐药性情况,为在医院获得性感染预防和诊治工作中提供依据。方法 收集我院2016年6月到2019年6月神经外科639例住院患者诊断为医院获得性感染738例的病原菌结果,分析不同病原菌特点及药敏结果。结果 738例医院获得性感染病例中医院获得性肺炎377例、泌尿系统感染130例、血流感染109例、中枢神经系统感染106例及其他部位感染16例。铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌为主要致病菌。临床常用重要抗菌药物中,大肠埃希菌和肺炎克雷伯菌对头孢曲松耐药率分别是62.1%和56.25%,对亚胺培南耐药率分别是2.01%和16.4%;铜绿假单胞菌耐药率≤30%;鲍曼不动杆菌除米诺环素外耐药率≥50%;金黄色葡萄球菌中耐甲氧西林率是61.29%,凝固酶阴性葡萄球菌耐甲氧西林率是79.23%,未发现葡萄球菌属对万古霉素、利奈唑胺和替加环素耐药;念珠菌属耐药率≤10%。结论 神经外科住院患者医院获得性感染以革兰阴性菌和葡萄球菌属为主,耐药情况严重,在临床预防和诊治中应根据不同病原菌特点及本院耐药监测结果合理使用抗菌药物。

关键词: 神经外科, 医院获得性感染, 病原菌, 耐药性