儿童开颅术后颅内感染多重耐药菌诊治分析
董燕,杜开先,张晓莉,贾天明
摘要(Abstract)：
目的分析开颅术后颅内感染儿童脑脊液培养为多重耐药菌的菌株特点、药敏试验结果及诊治情况,为临床合理用药提供参考。方法对1a中开颅术后颅内感染耐药菌共10株进行细菌鉴定及药敏测定,对其诊治进行回顾性分析。结果开颅术后颅内感染多重耐药菌以革兰阳性球菌为主(70%),革兰阴性杆菌检出率为30%。革兰阳性球菌对万古霉素、利奈唑胺、替考拉宁等敏感率100%,其次为庆大霉素(71.43%),对常用药物头孢唑啉、苯唑西林等耐药性高(均85.71%);革兰阴性菌对碳青霉烯类敏感性100%,对头孢西丁、左氧氟沙星、复方新诺明等敏感性66.67%,对哌拉西林他唑巴坦、头孢哌酮舒巴坦等耐药性高(66.67%)。5例应用万古霉素,1例应用万古霉素联合克林霉素,2例应用美罗培南,6例脑脊液培养转阴,2例尚未转阴放弃治疗。结论开颅术后颅内感染耐药菌对常见头孢类、青霉素类普遍耐药,以革兰阳性球菌为主,对万古霉素、利奈唑胺敏感;革兰阴性菌对碳青霉烯类敏感。临床医生应根据该类患者特点合理应用抗生素以提高治愈率、缩短住院时间。
关键词(KeyWords)： 儿童;开颅术;颅内感染;多重耐药
基金项目(Foundation):
作者(Author): 董燕,杜开先,张晓莉,贾天明
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