骨科伤口感染的病原学及药敏分析  

Etiology and drug sensitivity analysis of wound infection in department of orthopaedics

作　　者：张瑞霞[1] 杨义明[2] 

机构地区：[1]新乡医学院附属第一医院检验科,河南卫辉453100 [2]重庆医科大学检验系,400016

出　　处：《国际检验医学杂志》2007年第1期25-27,共3页International Journal of Laboratory Medicine

摘　　要：目的研究引起骨科伤口感染的常见病原体种类及对其敏感的药物。方法对我院2004年1月～2005年12月骨科伤口分泌物、脓液、穿刺液中分离出的阳性标本中的病原体种类及药敏试验进行综合分析。结果91例阳性标本中，共分离出27种93株病原菌。其中革兰阳性（G^＋）球菌45株，占48．4％；革兰阴性（G^-）杆菌46株，占49．4％；G^＋杆菌2株，占2．2％。感染率较高的病原菌为：金黄色葡萄球菌（15．0％）、表皮葡萄球菌（10．7％）、鲍曼不动杆菌（10．7％）、大肠杆菌（9．7％）。药敏结果显示：所选的药物中，对G^＋球菌敏感性较高的药物有万古霉素（82．2％）、利福平（60％）、复方新诺明（53．3％）、四环素（51．1％）。对G^-杆菌敏感性较高的药物只有亚胺硫霉素达到80．4％，其余均低于50％。结论在我院引起骨科伤口感染的病原菌中，G^＋球菌与G^-杆菌感染率相当，细菌种类繁多，以金黄色葡萄球菌、表皮葡萄球菌、鲍曼不动杆菌、大肠杆菌感染率较高。细菌耐药严重，可选用的抗生素已越来越少。因此，临床应根据细菌培养及药敏试验，合理使用抗生素，以减少耐药菌株的产生。Objective To study common pathogen category and its sensitive drugs of wound infection in department of orthopaedics. Methods From January 2004 to December 2005, pathogen category and drugs sensitivity of positive samples from wound secreta,liquor puris, pucture fluid were analyzed comprehensively. Results 27 species and 93 strains of pathogenic bacteria were separated from 91 positive samples. Gram-positive coccobacteria 45 strains, accounted for 48.4% ; Gram-negative bacillus 46 strains,accounted for 49.4% ; Gram-positive bacillus 2 strain, accounted for 2.2%. The higher infectious rate was ： staphylococcus aureus （15.0%） ,staphylococcus epidermidis （10.7%）, baumanii （10. 7%）, Bacterium coli （9.7%）. Result of drug sensitivity displayed ： the drugs sensitive tO Gram-positive coccobacteria were vancocin （82.2 % ）, rifampicin （60. 0 % ）, chemitrim （53.3 % ）, ambramycin （51.1%）. the drug sensitive to Gram-negative bacillus was only imipenem （80. 4%）, the rest lowered 50%. Conclusion The rate of Gram-positive coccobacteria and Gram-negative bacillus was alike for pathogenic bacteria of wound infection in department of orthopaedics in our hospital. The strains of higher infection rate were Staphylococcus aureus, Staphylococcus epidermidis, baumanii, Bacterium coli. Antibiotics applied were becoming fewer and fewer because of drug resistance. It is suggested that antibiotics should be reasonably applied according to bacterial culture and drug sensitivity in order to decrease generation of drug resistant strain.

关 键 词：外科伤口感染/微生物学 微生物敏感性试验 矫形外科手术 

分 类 号：R683[医药卫生—骨科学]