Distribution Of Multidrug-resistant G~+ Bacteria In Intracranial Infection And Evaluation Of The Efficacy And Safety On Vancomycin And Linezolin Therapy This Bacteria Infection

Object:(1)The distribution characteristics and drug suscePtibility of multiPle resistant gram-Positive bacteria in intracranial infection were analyzed.(2)Analysis the initial cause of intracranial infection.According to the relevant criteria of clinical efficacy evaluation,evaluate the efficacy and safety of vancomycin and linezolid in the treatment of intracranial multidrug-resistant G~+bacterial infection.(3)It is expected to provide reference for clinical optimization of drug selection and theoretical support for the development of authoritative literature on expert consensus and clinical guidelines for the treatment of intracranial infection.Method:Search 259 cases of cerebrospinal fluid specimens included in the 4986 positive specimens sent from June 2017 to June 2019 and 202 were multi-drug resistant.According to the inclusion criteria,124 patients who were treated with vancomycin or linezolid for intracranial multi-drug resistant gram-positive bacterial infection were selected as subjects for retrospective analysis.According to the different drugs used,it was divided into vancomycin group(n=72)and linezolid group(n=52).According to the evaluation indicators,the data were statistically analyzed to evaluate the clinical efficacy and safety of vancomycin and linezolid in the treatment of intracranial drug-resistant positive bacterial infections.Result:1?There were 4986 Positive samPles were sent for examination,including 259cerebrosPinal fluid samPles and 202 multi drug resistant samPles(77.69%).The top four bacteria were Staphylococcus epidermidis(n=91,35.14%),Staphylococcus hominis(n=29,11.20%),Staphylococcus capitis(n=29,11.20%),Staphylococcus haemolyticus(n=27,10.42%),Streptococcus viridans(n=20,7.72%).here was no resistance to vancomycin or linezolid in this study.The drug resistance rates of CSF strains to penicillin,benzoxicillin,ampicillin sulbacillin,amoxicillin clavulanate and ceftriaxone were all greater than 75%2?Most of the intracranial infections were caused by intracerebral hemorrhage(28.23%),craniocerebral injury(19.35%),subarachnoid hemorrhage(19.35%)and intracranial tumor(24.19%)as the initial cause,116 of 124 patients All patients had central nervous system infection after craniocerebral surgery.3?Compared with vancomycin group,the clinical effective rate(88.46%VS 62.50%)and bacterial clearance rate(78.84%VS 47.22%)of linezolid treatment group were significantly better than vancomycin group(P<0.05).The incidence of total adverse reactions in the linezolid group was significantly lower than that in the vancomycin group(15.38%VS 25.00%)(P>0.05).Conclusion:For patients with cerebral hemorrhage,craniocerebral injury and intracranial tumors,intracranial infections are very likely to occur after craniocerebral surgery;the pathogenic bacteria are mainly Gram-positive bacteria.This study showed that linezolid was superior to vancomycin in clinical efficacy and safety in the treatment of intracranial multidrug-resistant gram-positive bacterial infection,and was worthy of clinical promotion.Therefore,it is of great significance for patients with intracranial infections to choose linezolid for anti-infective treatment early after craniocerebral operation.