2009-2012年伤口分泌物病原菌分布及耐药研究  

Distribution and drug resistance of bacteria isolated from wound secretions in 2009-2012

作　　者：缪应业[1] 谢国旗[2] 刘新[2] 李浩[1] 郭照静[1] 谢效兵 杨继勇[3] 

机构地区：[1]解放军152医院检验科,河南平顶山467000 [2]解放军152医院医务处,河南平顶山467000 [3]解放军总医院微生物科,北京100853

出　　处：《中华医院感染学杂志》2014年第3期585-587,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(31172166;81171367)

摘　　要：目的对医院自伤口分泌物分离病原菌的种类和耐药性进行回顾性分析,为临床抗感染治疗提供依据。方法使用法国生物梅里埃公司API鉴定系统进行细菌菌种鉴定;纸片扩散法检测药物敏感性;WHONET 5.4软件对耐药数据进行统计分析。结果 2009年1月-2012年12月医院自伤口分泌物共分离出细菌420株,其中,革兰阳性球菌160株占38.1%,革兰阴性杆菌260株占61.9%;检出前5位的细菌依次为大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌、弗氏柠檬酸杆菌,分别占24.3%、21.9%、11%、9%和6.9%;37.8%的金黄色葡萄球菌为耐甲氧西林金黄色葡萄球菌(MRSA);大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)的菌株分别占62.8%和45.3%。结论医院伤口分泌物分离细菌的菌种类别较多,不同细菌的耐药性存在一定差异,快速、准确的病原学诊断以及对此类感染病原菌的监测工作对于创伤感染的抗感染治疗十分必要。OBJECTIVE To investigate the distribution and drug resistance of the pathogenic bacteria isolated from wound secretions so as to guide the clinical anti-infection therapy. METHODS The pathogenic bacteria were identified with the use of API identification system of Merieux, France, the drug susceptibility testing was performed by using disc diffusion method, and the data of drug resistance were statistically analyzed with the use of WHONET 5.4 software. RESULTS From Jan 2009 to Dec 2012, a total of 420 strains of pathogenic bacteria have been isolated from the wound secretions, a total of 420 strains of bacteria were isolated from wound secretions, there were 160 （38.1% ） strains of gram-positive cocci and 260（61.9%） strains of gram-negative bacil- li; the Escherichia coli （24.3 %）, Staphylococcus aureus （21.9 %） , Pseudomonas aeruginosa （11 %） , Klebsiella pneumoniae （9%）, and Citrobacterfreundii （6.9%） ranked the top 5 specie of pathogens. 37.8% of S. aureus strains were methicillin-resistant S. aureus; extended-spectrum β-lactamase （ESBLs）-producing E. coli and K. pneumoniae accounted for 62. 8% and 45. 3%, respectively. CONCLUSION There are a variety of species of bacteria isolated from the wound secretions, which vary in the drug resistance; the rapid and accurate etiological diagnosis and the monitoring of such pathogens causing infections are very important for the treatment of wound infections.

关 键 词：伤口分泌物 细菌 分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]