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凝固酶阴性葡萄球菌:中枢神经系统分流感染中的新兴病原体。

Coagulase-negative staphylococci: Emerging pathogen in central nervous system shunt infection.

作者信息

Bhatia Preeti Lata, Lilani Sunil, Shirpurkar Ritesh, Chande Chhaya, Joshi Shrikant, Chowdhary Abhay

机构信息

Department of Microbiology, Grant Government Medical College and Sir J.J. Group of Hospitals, Byculla, Mumbai, Maharashtra, India.

出版信息

Indian J Med Microbiol. 2017 Jan-Mar;35(1):120-123. doi: 10.4103/ijmm.IJMM_16_157.

Abstract

Central nervous system (CNS) shunts are commonly used to treat patients with hydrocephalus. Its placement is associated with increased risk of infection. The study was intended to evaluate infection rate associated with CNS shunt surgeries and identify risk factors for shunt infection. The frequency and characterisation of aetiological agents along with their antibiotic resistance pattern were also studied. A prospective study of 86 patients who underwent 97 surgeries over a period of 18 months was conducted. One hundred seventy-six cerebrospinal fluid samples and 44 shunt tips obtained were processed using standard microbiological techniques. Of 86 patients, 39 (45.35%) operated for shunt revision were infected while 47 patients operated for shunt insertion were not found to be infected. Methicillin-resistant Staphylococcus epidermidis was the predominant isolate. 57.58% isolates of Staphylococci were found to be biofilm producers. Mortality of 15% was observed among infected patients. Shunt infection remains a serious issue in the patients undergoing shunt surgery. Accurate diagnosis, treatment and prevention of infection are essential in such patients.

摘要

中枢神经系统(CNS)分流术常用于治疗脑积水患者。其植入与感染风险增加相关。本研究旨在评估与CNS分流术相关的感染率,并确定分流感染的危险因素。同时还研究了病原体的频率、特征及其抗生素耐药模式。对86例患者进行了一项前瞻性研究,这些患者在18个月内接受了97次手术。使用标准微生物技术对获取的176份脑脊液样本和44个分流管尖端进行了处理。86例患者中,39例(45.35%)因分流管翻修手术而感染,而47例接受分流管植入手术的患者未发现感染。耐甲氧西林表皮葡萄球菌是主要分离菌株。发现57.58%的葡萄球菌分离株可产生生物膜。感染患者的死亡率为15%。分流感染在接受分流手术的患者中仍然是一个严重问题。对此类患者进行准确的诊断、治疗和预防感染至关重要。

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