| Objective: To understand the distribution of pathogenic bacterial flora and drug sensitivity in intracranial infection after neurosurgical craniotomy,and to provide reference for improving clinical understanding of the etiology and drug sensitivity of intracranial infection and standardizing the rational use of intracranial infection antibacterial drugs in accordance with.Methods: To retrospectively analyze the results of cerebrospinal fluid bacterial and fungal culture and drug susceptibility tests in 433 patients who were diagnosed with intracranial infection after craniotomy at the Neurosurgery Department of the First Affiliated Hospital of Guangxi Medical University from January 2017 to December 2019,Compare and analyze the distribution of the pathogenic bacteria and the drug susceptibility in the culture.Results: A total of 3124 cases of craniotomy were performed in the past three years.A total of 464 cases of intracranial infection occurred after surgery,with an infection rate of 14.85%.31 patients who did not meet the inclusion criteria of this study were removed.A total of 433 patients were included,and1168 cerebrospinal fluid samples were sent for examination.The repeated strains cultured by the same patient in a single hospitalization were eliminated.Finally,112 strains of pathogenic bacteria were co-cultivated.The detection rate of patients with intracranial infection was 25.87%.The detection rate of CSF samples sent was 9.59%.Among them,91 strains of Gram-positive bacteria(81.25%)were cultured.The most common ones were coagulase-negative Staphylococcus aureus,Staphylococcus aureus,Micrococcus roseus,Corynebacterium and other Gram-positive bacteria.A total of 21 strains of Gram-negative bacteria(accounting for 18.75%)were cultured.The most common were Acinetobacter baumannii,Escherichia coli,and other Gram-negative bacteria.No fungus was detected in 433 patients.Gram-positive bacteria are still the main pathogen in intracranial infection after craniotomy,but the proportion of Gram-negative bacteria has an upward trend.A total of 79 strains of coagulase-negative staphylococci were detected,the most common of which were Staphylococcus epidermidis(32.91%),Staphylococcus hemolyticus(27.85%),Staphylococcus head(12.66%),Staphylococcus humane(12.66%),Staphylococcus corydalis(6.33%).In the susceptibility test results,the detection rates of methicillin-resistant coagulase-negative staphylococci(MRCNS)and methicillin-sensitive coagulase-negative staphylococci(MSCNS)were 70.42%and 29.58%,respectively.The antimicrobial drugs with high sensitivity of MRCNS are linezolid,vancomycin and tigecycline,and those with high resistance are benzylpenicillin and oxacillin.The antimicrobial drugs with high MSCNS sensitivity are linezolid,vancomycin,tigecycline,moxifloxacin,and ciprofloxacin,and the drug resistance is benzylpenicillin.The difference was statistically significant(p<0.05).The highly sensitive antibacterial drugs in Gram-negative bacteria are amikacin,minocycline,cefepime,piperacillin/tazobactam,meropenem,imipenem,cefoperazone/Sulbactam,the high resistance was ampicillin and cefuroxime,the difference was statistically significant(p<0.05).Conclusion: The pathogenic flora of patients with intracranial infection after neurosurgical craniotomy is mainly coagulase-negative staphylococcus.The pathogenic flora has different degrees of resistance to antibacterial drugs,so clinical monitoring of pathogens should be strengthened according to drug resistance,and reasonable selection of antibacterial drugs. |
