中文摘要：

目的探讨神经外科患者术后颅内感染的病原菌分布及耐药性,以降低感染率。方法选取2012年1月-2014年1月医院神经外科收治的患者1 900例作为研究对象,采集患者脑脊液（CSF）进行细菌培养和耐药试验;选取2015年1-8月入院神经外科患者40例,分别于手术当天术后第1、3、7d用无菌棉拭子采集头皮标本,进行培养并检测药物敏感性。结果 1 900例患者共有179例发生颅内感染,感染率为9.42%,CSF中检出病原菌163株,革兰阳性菌119株占73.01%,革兰阴性菌44株占26.99%;收集40例患者160份头皮标本,共培养病原菌160株,其中以革兰阳性菌143株占89.37%,革兰阴性菌5株占3.13%,真菌12株占7.5%;CSF中的革兰阳性菌对万古霉素敏感,未检出耐药菌株,头皮标本中对万古霉素同样敏感,仅检出5株耐药菌,耐药率3.13%;CSF中耐药性较高的为苯唑西林和青霉素,耐药率分别为83.19%和79.83%,头皮标本中对青霉素全部耐药;CSF中的革兰阴性菌耐药性最高的为卡那霉素,耐药率为52.27%,头皮标本中的革兰阴性菌仅5株,均对头孢吡肟和头孢他啶100.00%耐药。结论革兰阳性菌尤其是凝固酶阴性葡萄球菌和金黄色葡萄球菌是引起颅内感染的重要因素,临床应在术前或术中使用针对革兰阳性菌的广谱抗菌药物。

英文摘要：

OBJECTIVE To explore the distribution and drug resistance of pathogens causing postoperative intracranial infections in patients of neurosurgery department so as to reduce the infection rate.METHODS A total of 1 900 patients who were treated in the department of neurosurgery from Jan 2012 to Jan 2014 were recruited as the study objects,and the cerebrospinal fluid（CSF）specimens were collected for the bacterial culture and drug susceptibility testing;totally 40 patients who were hospitalized the department of neurosurgery were enrolled in the study,then the scalp specimens were collected by using sterile cotton swab on the day of surgery,or Day 1,3,or 7after the surgery,the bacterial culturing was conducted,and the drug susceptibility testing was performed.RESULTS The intracranial infections occurred in 179 of 1 900 patients,with the infection rate of 9.42%.A total of 163 strains of pathogens were isolated from the CSF specimens,including 119（73.01%）strains of gram-positive bacteria and 44（26.99%）strains of gram-negative bacteria.Totally 160 strains of pathogens were isolated from 160 scalp specimens that were obtained from 40 patients,including 143（89.37%）strains of gram-positive bacteria,5（3.13%）strains of gram-negative bacteria,and 12（7.5%）strains of fungi.The gram-positive bacteria isolated from the CSF specimens were susceptible to vancomycin,and the drug-resistant strains were not found;the gram-positive bacteria isolated from the scalp specimens were also susceptible to vancomycin,only 5drug-resistant strains were found.The drug resistance rates of the pathogens isolated from the CSF specimens to oxacillin and penicillin were83.19% and 79.83%,respectively;all of the pathogens isolated from the scalp specimens were resistant to penicillin.The drug resistance rate of the gram-negative bacteria isolated from the CSF specimens to kanamycin was the highest（52.27%）;the drug resistance rates of the 5strains of gram-negative bacteria isolated from the scalp specimens to cefepime and cefta