骨科患者伤口感染的病原菌分布及耐药性分析  

Clinical distribution and drug resistance of pathogens causing wound infections in patients of department of orthopedics

作　　者：王娜[1] 李少侠[1] 张莎莎[1] 常世卿[1] 

机构地区：[1]河南省洛阳正骨医院检验中心,河南洛阳471002

出　　处：《中华医院感染学杂志》2014年第7期1603-1605,共3页Chinese Journal of Nosocomiology

基　　金：洛阳市应用技术与开发基金项目(1101057A)

摘　　要：目的了解骨科患者伤口感染的常见病原菌分布及耐药性,为临床合理应用抗菌药物、减少医院感染提供科学依据。方法回顾性调查2007年5月-2012年10月骨科患者伤口感染的临床现状,对感染患者送检的380份标本严格按照《全国临床检验操作规程》进行细菌接种和培养,对检出的病原菌采用纸片扩散法(K-B法)进行药敏试验,结果进行统计分析,按照美国临床实验室标准化委员会(NCCLS)的标准对培养结果进行判断。结果骨科感染患者送检的380份标本分离的185株病原菌,革兰阴性杆菌108株占58.4%,革兰阳性球菌70株占37.8%,真菌7株占3.8%;革兰阴性杆菌主要为假单胞菌属及克雷伯菌属等,革兰阳性球菌主要为凝固酶阴性葡萄球菌及金黄色葡萄球菌;多数细菌耐药性较高,假单胞菌属对头孢他啶及环丙沙星的耐药率较低,分别为16.3%、23.3%;凝固酶阴性葡萄球菌对万古霉素100.0%敏感,对其他抗菌药物的耐药率均>50.0%。结论抗菌药物的广泛应用,使条件病原菌成为骨科患者伤口分离的重要病原菌,临床医师应根据骨科患者伤口感染的细菌学检查结果,合理应用抗菌药物,采取有效措施积极预防和控制感染。OBJECTIVE To investigate the clinical distribution and drug resistance of pathogens causing wound infections in patients of department of orthopedics so as to provide scientific bases for reasonable clinical use of antibiotics and reduction of incidence of nosocomial infections .METHODS From May 2007 to Oct 2012 ,a retro-spective survey was conducted for the current status of wound infections in patients of department of orthopedics , then totally 380 submitted specimens obtained from the patients with infections were cultured by strictly confor-ming to the national clinical test procedures , the drug susceptibility testing of the isolated pathogens was performed with the use of disk diffusion method （K-B method） ,the result was statistically analyzed ,and the cul-ture result was determined according to the standards of National Committee of Clinical Laboratory Standardiza -tion .RESULTS A total of 185 strains of pathogens have been isolated from the 380 submitted specimens ,including 108 （58 .4% ） strains of gram-negative bacilli ,70 （37 .8% ） strains of gram-positive cocci ,and 7 （3 .8% ） strains of fungi;the Pseudomonas and K lebsiella were dominant among the gram-negative bacilli ;the coagulase-negative Staphylococcus and Staphylococcus aureus were the predominant species of gram-positive cocci .The majority of the pathogens were highly drug-resistant , and the drug resistance rates of Pseudomonas to ceftazidime and ciprofloxacin were 16 .3% and 23 .3% ,respectively ;the coagulase-negative Staphylococcus strains were 100 .0%susceptible to vancomycin , and the drug resistance rates to other antibiotics were more than 50 .0% . CONCLUSION The opportunistic pathogens have become the major pathogens causing wound infections in the patients of department of orthopedics due to extensive use of antibiotics .It is necessary for the clinicians to reason-ably use antibiotics based on the bacteriological examination result and take effective measures for prevention and control of infections .

关 键 词：骨科 病原菌 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]