骨科住院患者感染病原菌分布及耐药性分析  

Pathogens Distribution of Hospital Infection and Their Drug Resistance in Department of Orthopedics

作　　者：陈希莲[1] 朱德全[1] 

机构地区：[1]临沂市人民医院骨科,山东临沂276003

出　　处：《中华医院感染学杂志》2008年第4期570-573,共4页Chinese Journal of Nosocomiology

摘　　要：目的评估骨与关节化脓性感染的主要病原菌、耐药性演变情况,为临床抗菌药物治疗提供依据。方法回顾性分析2004年4月-2007年4月骨科感染患者的各类标本中分离出的病原菌,采用VITEK-32进行细菌鉴定和药敏分析,部分药敏采用K-B纸片扩散法和Etest法进行。结果铜绿假单胞菌、金黄色葡萄球菌、溶血葡萄球菌、表皮葡萄球菌和鲍氏不动杆菌检出率最高,分别为17.08%、14.76%、12.94%、12.27%、9.65%;耐甲氧西林金黄色葡萄球菌>60.00%,革兰阳性球菌占47.76%,革兰阴性杆菌占43.78%,假丝酵母菌属占7.96%;葡萄球菌属是骨科患者感染的主要病原菌,对多种抗菌药物耐药。结论耐药的葡萄球菌属是骨与关节化脓性感染的主要病原菌;其次是鲍氏不动杆菌和铜绿假单胞菌;抗菌药物使用前应常规进行培养,选用敏感的抗菌药物并根据药敏试验结果调整用药,以减少慢性病变的发生。OBJECTIVE To evaluate the pathogens in department of orthopedics infection and the bacterial resistance to antibiotics,and to provide reference of clinical antibiotic therapy.METHODS A total of 603 pathogenic strains isolated from patients with bone and joint purulent infection,from Apr 2004 to Apr 2007 were retrospectively analyzed with the results of their bacterial cultures and antibiotics sensitivity tests by VITEK32,a part of antibiotics sensitivity tests by K-B and Etest.RESULTS The inspection rate of Pseudomonas aeruginosa,Staphylococcus aureus,S.haemolyticus,S.epidermidis,and Acinetobacter baumannii were 17.08%,14.76%,12.94%,12.27% and 9.65%,respectively.Meticillin-resistant S.aureus（MRSA）was higher than 60.00%,pathogen rate of Gram-positive cocci,Gram-negative bacteria,and Candida were 47.76%,43.78%,and 7.96%,respectively.Staphylococcus were major pathogens of bone and joint purulent infection,multidrug-resistant Staphylococcus infections have increased.CONCLUSIONS Bone and joint purulent infection is mainly caused by Staphylococcus which resist to many antibiotics,A.baumannii and P.aeruginosa are also often found these years.Routine blood culture before using of antibiotics should be taken.The sensitive antibiotics are selected and adjusted according to the results of blood culture and sensitivity test.

关 键 词：感染 耐药性 病原菌 

分 类 号：R378.1[医药卫生—病原生物学]