开放性外伤患者感染病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens causing infections in open trauma patients

作　　者：陈洪流[1] 谭庆丰[1] 陈文革[1] 

机构地区：[1]湖北民族学院附属民大医院普外二科,湖北恩施445000

出　　处：《中华医院感染学杂志》2014年第4期838-840,共3页Chinese Journal of Nosocomiology

基　　金：湖北省社会发展科技计划基金资助项目(2013B21)

摘　　要：目的研究开放性外伤患者感染病原菌分布特点及耐药率,为临床抗菌药物的使用提供指导依据。方法回顾性分析医院2010年1月-2013年1月157例开放性外伤患者感染创面分泌物细菌培养及药敏率,采用WHONET5.4软件对研究数据进行统计分析。结果 157例开放性外伤患者培养阳性标本中,共检出病原菌189株,其中革兰阳性球菌148株占78.31%,较为常见的为金黄色葡萄球菌60株占31.75%、表皮葡萄球菌33株占17.46%、腐生葡萄球菌27株占14.29%;检出革兰阴性杆菌38株占20.10%,其中铜绿假单胞菌16株占8.46%、大肠埃希菌14株占7.41%;真菌检出3株占1.59%;3种主要革兰阳性球菌对临床常见的抗菌药物均呈现不同程度的耐药现象,其中青霉素G耐药均>70.00%,万古霉素、替考拉宁耐药率均为100.00%;两种主要革兰阴性杆菌铜绿假单胞菌及大肠埃希菌对亚胺培南未发现耐药菌株,铜绿假单胞菌对美罗培南的耐药率为6.25%,大肠埃希菌未发现耐药菌株,其他均呈现不同程度耐药。结论开放性创伤患者感染高发,根据药敏试验合理选择抗菌药物是有效控制感染的关键。OBJECTIVE To study the characteristics of distribution of pathogens causing infections in the open trauma patients and analyze the drug resistance so as to provide guidance for clinical use of antibiotics. METHODS Totally 157 cases of open trauma patients who were treated in the hospital from Jan 2010 to Jan 2013 were enrolled in the study, then the bacterial culture of wound secretions and the drug susceptibility rates were retrospectively analyzed, and the statistical analysis was performed with the use of WHONET software. RESULTS A total of 189 strains of pathogens have been isolated from the positive specimens obtained from the 157 open trauma patients, including 148 （78.31%） strains of gram-positive cocci, 38 （20. 10%） strains of gram-negative bacilli, and 3 （1.59%） strains of fungi; the Staphylococcus aureus （60 strains）, S. epidermidis （33 strains）, and S. sapro- phyticus（ 27 strains ） were the common species of gram-positive cocci, accounting for 31. 750/oo, 17. 46//00, and 14.29 , respectively; the Pseudornonas aeruginosa （16 strains） and Escherichia coli （14 strains ） were dominant among the gram-negative bacilli, accounting for 8.46 and 7. 41 /00, respectively. The three main species of gram- positive cocci varied in the drug resistance to the commonly used antibiotics, the drug resistance rate to penicillin G was more than 70.00, and the drug resistance rates to vancomycin and teicoplanin were 100.00 ; while the imipenem-resistant P. aeruginosa or E. coli strains have not been detected, the drug resistance rate of the P. aeruginosa to meropenem was 6. 25, the meropenem-resistant E. coli strains have not been found, and the strains varied in the drug resistance to other antibiotics. CONCLUSION The incidence of infections is high in the open trauma patients; it is the key to reasonably use antibiotics according to drug susceptibility testing so as to effectively control the infections.

关 键 词：开放性外伤 感染 病原菌 分布 药敏率 

分 类 号：R378[医药卫生—病原生物学]