Classification of Pathogenic Bacteria in Cerebrospinal Fluid of Patients with Intracranial Infection After Neurosurgery and Selective Use of Antibacterial Agents

Anti-infective treatment has become troublesome owing to aggravated resistance to antibacterial agents.
This study aimed at investigating the distribution characteristics and drug resistance changes of pathogenic bacteria in cerebrospinal fluid (CSF) of patients with intracranial infection receiving neurosurgery, and to provide evidence for rational use of antibacterial agents.
Bacteria were collected from CSF cultures of all patients receiving neurosurgery in the hospital of the current research, from January 2013 to December 2015, and the same types of strains cultured from each case during the same infection were combined. A hospital information system (HIS) was then used to analyze the data of 120 patients, who received neurosurgery from January 2015 to June 2016 and had positive CSF bacterial culture results after surgery, and to treat them by rationally selecting antibacterial agents.
A total of 845 pathogenic bacterial strains were isolated from the CSF samples and cultured, of which 629 were Gram-negative bacteria, accounting for 74.4%. Particularly, Acinetobacter baumannii had severe pan-resistance. There were 216 Gram-positive bacteria, which accounted for 25.6% of all strains, and were mainly methicillin-resistant staphylococci, being basically resistant to penicillins and only susceptible to vancomycin and linezolid. After rational selection of antibacterial agents using HIS, based on the retrospective analysis results, 101 of the 120 patients were cured by vancomycin and linezolid (cure rate: 84.17%).
Since the treatment outcomes after rational selection of antibacterial agents (i.e. vancomycin and linezolid) using HIS were satisfactory, the findings of retrospective analysis are of high clinical value.