摘要
目的:分析医院骨科患者手术切口感染病原菌特点及其耐药性,为控制骨科手术切口感染发生率及临床合理用药提供参照。方法:随机抽取本院骨科2011年8月-2014年10月收治的300例手术切口感染患者作为研究对象,采集所有患者手术切口感染标本,分离病原菌,采用全自动细菌分析仪鉴定病原菌种类,分析其耐药性。结果:300例骨科手术切口感染患者共计培养处病原菌920株。标本来源:分泌物及脓液818株,占88.9%,血液33株,占3.6%,引流液32株,占3.5%,关节积液27株,占2.9%,其他10株,占1.1%。920株致病菌中,革兰阴性杆菌597株,占64.9%;革兰阳性球菌171株,占18.6%;真菌152株,占16.5%;骨科手术切口感染主要病原菌为革兰阴性杆菌,其中以铜绿假单胞菌位居第一,占32.6%,其次则为鲍氏不动杆菌,占13.0%。革兰阳性球菌是引起骨科手术切口感染的第二位病原菌,其中金黄色葡萄球菌是导致感染的首位病原菌,占12.4%。真菌则为引起骨科手术切口感染的第三位菌群,其中以感染白色假丝酵母菌为主,占7.8%;革兰阴性杆菌对阿米卡星、氨曲南、哌拉西林、头孢吡肟、替卡西林、左氧氟沙星、头孢唑林有较高的耐药率,革兰阳性球菌则对左氧氟沙星、头孢西丁、青霉素、克林霉素有较高的耐药率。结论:在骨科应用抗生素治疗时需严格参照病原菌检查结果,并根据药物敏感性实验结果确定临床用药种类,展开针对性、个体化的治疗,以优化抗感染治疗效果,降低术后感染发生率。
Objective：To analyze the characteristics and drug resistance of pathogenic bacteria in operative incision infection of orthopedics patients,to provide reference of controlling the operation incision infection incidence in department of orthopedics and clinical rational drug use. Method：300 incision infectious patients as the research objects in department of orthopedics in our hospital from August 2011 to October 2014,were collected the surgical incision infection specimens,isolated pathogenic bacteria,using automatic analyzer in detection of bacterial pathogens and analysis of drug resistance. Result：300 cases with a total of 920 strains of pathogenic bacteria cultured in department of orthopedics,patients with surgical incision infection and pus secretion specimen source：818 strains accounted for 88.9%, 33 from blood,accounted for 3.6%,drainage of 32 strains,accounted for 3.5%,27 cases of joint effusion,accounted for 2.9%,other 10 strains,accounted for 1.1%. 920 strains of pathogenic bacteria,597 strains of gram negative bacilli, accounted for 64.9%;171 strains of gram positive coccus,accounted for 18.6%;152 strains of fungi,accounted for 16.5%;incision infection in department of orthopedics was mainly pathogenic bacteria of gram negative bacilli,which pseudomonas aeruginosa ranked first,accounting for 32.6%,followed by Acinetobacter baumannii,accounted for 13%. Gram positive coccus was the second pathogens caused operation incision in department of orthopedics infection,including Staphylococcus aureus was the leading pathogen infection,accounted for 12.4%. The fungus was the third bacteria caused operation incision infection in department of orthopedics,which infected with Candida albicans,accounted for 7.8%;gram negative bacilli had higher rate to Amikacin,aztreonam,Pi La Shilling,cefepime,ticarcillin,resistant to levofloxacin,cefazolin,gram positive coccus had high resistance rate on the left ofloxacin,cefoxitin,penicillin, clindamycin. Conclusion：In application of antibiotic therapy in department of orthopedics must strictly according to pathogenic bacteria detection results,to determine the clinical medication types according to the result of drug sensitivity test,launch targeted,individual treatment,in order to optimize the anti infection treatment effect,reduce the incidence of postoperative infection.
出处
《中国医学创新》
CAS
2015年第13期112-115,共4页
Medical Innovation of China
关键词
骨科
切口感染
手术
病原菌
耐药性
Department of orthopedics
Incision infection
Surgery
Pathogen
Drug resistance
