创伤骨科病原菌分布及耐药谱分析  

Distribution of pathogens from orthopedic trauma department and drug resistant spectrum

作　　者：叶志军[1] 王文秋[1] 张小娟[1] 

机构地区：[1]佛山市中医院医院感染管理科,广东佛山528000

出　　处：《中华医院感染学杂志》2011年第6期1256-1258,共3页Chinese Journal of Nosocomiology

基　　金：广东省佛山市科技攻关项目(200808029)

摘　　要：目的调查3个创伤骨科病原菌分布特点,分析病原菌耐药性,对环境病原学监测,调查危险因素。方法用VITEK-ATB系统对医院2008年1月1日-2010年6月30日不同创伤骨科患者伤口感染病原菌的监测资料和耐药性进行统计分析,聚集性感染病例发生时对病房环境采样,进行相关危险因素调查。结果医院3个创伤骨科伤口感染主要病原菌是铜绿假单胞菌、大肠埃希菌、金黄色葡萄球菌、鲍氏不动杆菌、肠球菌属,分别占27.9%、22.4%、17.2%、17.2%、15.4%;因收治病种各有不同特点,主要病原菌排位不同,排首位者多为铜绿假单胞菌;聚集性感染病例时环境中未发现有相同致病菌;铜绿假单胞菌对常用抗菌药物保持较高敏感性,鲍氏不动杆菌对多种常用抗菌药物的耐药率>60.0%;金黄色葡萄球菌对克林霉素的耐药性>50.0%,不适用于创伤骨科的经验性抗感染治疗。结论医院感染管理部门应经常监测本单位的病原菌分布,掌握病原菌对抗菌药物的敏感性及耐药性特征,指导临床根据药敏结果针对性地选用抗菌药物。OBJECTIVE To investigate the distribution characteristics of pathogens and drug resistance situation of pathogenic bacteria,to monitor environmental pathogen,and to find out the risk factors in three orthopedic trauma departments.METHODS Statistical analysis was performed to those monitoring data and drug resistance of orthopedic trauma patients with wound infections with VITEK-ATB system in our hospital from Jan 1,2008 to Jun 30,2010,the samples from ward environment were collected when clusters of infections occurred and the associated risk factors.RESULTS Main pathogens of wound infection in the three orthopedic trauma wards in our hospital were Pseudomonas aeruginosa,Escherichia coli,Staphylococcus aureus,Acinetobacter baumannii and Enterococcus.The rank of the main pathogens was different due to the different cases,PAE was in the first row.No same pathogen in the environment when clustering of infections were found.PAE maintained a high sensitivity to antibacterial agents,the resistance rate of ABA was up to 60.0%.The drug resistant rate of S.aureus to clindamycin was over 50.0% and was not suitable for the empirical anti-infective treatment of orthopedic trauma.CONCLUSION The distribution of the pathogens should be monitored regularly by the department of nosocomial infection management,the sensitivity and drug resistance of the pathogens to antibiotics should be mastered,and the antibiotics should be applied according to the result of the drug sensitivity test.

关 键 词：创伤骨科 病原菌 耐药谱 

分 类 号：R378[医药卫生—病原生物学]