2300 were adults, cerebrospinal fluid culture and drug resistance analysis of strains
【Abstract】 Objective To summarize our hospital from January 2002 to June 2005 submission of the 2300 adults were CSF culture and drug sensitivity for the clinical diagnosis and treatment information. Methods used by the U.S. DADE Inc. Microscan Walkaway 40 automatic bacterial identification and antibiotic susceptibility analysis system for determination of bacterial identification and antimicrobial susceptibility.
Results in 2300 were cerebrospinal fluid samples, 180 were detected in the number of positive (7.83%), including 144 bacteria (98 Gram-positive bacteria, Gram-negative bacteria
46), 26 fungi, 10 strains of Mycobacterium tuberculosis.
Streptococcus and Enterococcus sensitive to penicillin, vancomycin against Gram-positive cocci have a high
antibacterial activity; Gram-negative bacteria to commonly
used drugs cefotaxime and ceftriaxone in the sensitivity of poor, carbapenem, aztreonam against gram-negative bacteria
have good antibacterial activity; part of the meningitis caused by Mycobacterium tuberculosis and fungi. Conclusion to nosocomial infection in this group mainly meningitis, suggesting that clinicians should be based on the
characteristics of patients with meningitis, personalized medicine and rational use of antibiotics.
Key words Cerebrospinal fluid drug-resistant pathogens
Analyses on the pathogens and their resistance to antibiotics
ABSTRACT Objective To analyze the pathogenic results and drug resistance of bacteria isolated from 2300 cerebrospinal fluild specimens of adults from 2002 to 2005 so as to provide evidence for clinical diagnosis and therapy of meningitis. Methods The bacteria identification and the
antimicrobial susceptibility were assayed by automatic bacteria culture device Microscan Walkaway 40 from DADE Co. Results The positive rate of pathogens was 7.83% (180/2300) from 2300 cerebrospinal fluild specimens.There were 144 strains of bacteria which include 98 Gram positive bacteria and 46 Gram negative bacteria, 26 fungi, and 10 Mycobacterium tuberculosis. Streptococcus spp. and Enterococcus spp. were sensitive to penicillin, all the Gram positive cocci were sensitive to vancomycin; the Gram negative bacteria were
resistant to routine antibiotics such as cefotaxime and ceftriaxone, while they have high percentage of susceptibility to aztreonam and carbapenems and some cases were infected with Mycobacterium tuberculosis and fungi. Conclusion It suggests
that clinicians should pay more attention to personalized therapy based on the characteristic of meningitis so as to attain rational use of antibiotics.
KEY WORDS Cerebrospinal fluild; Pathogen; Drug resistance
Purulent meningitis pathogens, including bacteria usually caused by acute purulent meningitis, and Mycobacterium tuberculosis, deep fungal caused by chronic meningitis, very great harm to mankind, the highest mortality of infectious diseases in the world top ten . The diagnosis of meningitis
pathogens rely on examination of cerebrospinal fluid, cerebrospinal fluid bacterial culture and sensitivity results of the clinician's diagnosis, medication, efficacy plays an important role in determining . With the social
environment, medical means of changing pathogens of meningitis pathogens composition, drug sensitivity worth exploring. In this paper, West China Hospital of Sichuan University from January 2002 to June 2005 of cerebrospinal fluid culture results were analyzed 2300 reported as follows.
1 Materials and methods
1.1 The object of study
West China Hospital of Sichuan University from January 2002 to June 2005 submission of the 2300 copies of cerebrospinal fluid specimens. 1.2 Specimen Collection
To aseptic technology to collect cerebrospinal fluid 3 ~ 5ml, set sterile containers for immediate submission.
1.3 Isolation and culture
CSF will be sent for inspection immediately inoculated rabbit which has been pre-heating and non-vancomycin-blood
agar plate of chocolate, as well as glucose broth by bacilli, the home 5% ~ 10% CO2 incubator box, culture 24h after the observation that if by bacilli in broth was cloudy or biofilm production, and then picked culture solution or membrane
translocation kinds of bacteria in blood agar, the bacteria were isolated and cultured to identify the steps according to the "national clinical laboratory operating procedures" to. Experiments with rabbit blood agar, chocolate plate without
vancomycin and glucose broth by bacilli are the West China Hospital clinical microbiology laboratory production, by the quality and pass the inspection before use.
1.4 Identification and antimicrobial susceptibility of bacteria
Experimenting with the use of instruments as the United States DADE Inc. Microscan Walkaway 40 automatic bacterial identification and antibiotic susceptibility analysis system (Dade MicroScan Inc., West Sacramento, CA, USA), according to the U.S. for Clinical Laboratory Standards Institute (CLSI /
NCCLS) (2004 year) documentation standards, micro-dilution MIC
values measured interpretation of the results of bacterial susceptibility of sensitive (S), intermediate (I), resistance (R). Ceftazidime (30μg) and ceftazidime / clavulanic acid (30
μg/10μg) and cefotaxime (30μg) and cefotaxime / clavulanic
acid (30μg/10μg) is greater than the difference between the inhibition zone diameter of 5mm judged to be producing ESBLs strain.
1.5 Quality control strains
Escherichia coli ATCC25922, Staphylococcus aureus ATCC25923 and Pseudomonas aeruginosa ATCC27853 by the Ministry of Health clinical testing centers.
2.1 In general
In the 2300 cerebrospinal fluid specimens were adults, and the detection of 180 copies of the number of positive (7.83%), including 144 bacteria (98 Gram-positive bacteria,
Gram-negative bacteria 46), fungal 26, Cryptococcus neoformans 22, like yeast-like fungi 4, 10 strains of Mycobacterium tuberculosis. Neurosurgery, Department of Infectious Diseases, Department of Neurology and other sections higher rate of positive separation (Tab.1, Tab.2). Reposted elsewhere in the paper for free download http://
2.2 The sensitivity analysis of cerebrospinal fluid isolates
Measured using micro-dilution method of MIC values of the results judged as sensitive, intermediate, resistant categories, Microscan Walkaway 40 system, the results of the sensitivity criterion and the United States for Clinical Laboratory Standards Institute (CLSI / NCCLS) document
standards. Results (Tab.3) showed that isolated from the cerebrospinal fluid in the Bowman / hemolytic Acinetobacter to imipenem, aztreonam sensitivity is better, resistance rates were 0 and 35.71%; right Amiga Star (resistance rate 71.43%),
compound I oxazole sulfamethoxazole (85.71%), ciprofloxacin (85.71%), gentamicin (85.71%), ceftriaxone (78.57%), cefotaxime (85.71 %) and tobramycin (71.43%), poor sensitivity. Escherichia coli isolated from seven in three producing ESBLs, imipenem and piperacillin / tazobactam sensitivity of good resistant rates were 0, to amikacin, cephalosporin