蛇咬伤患者创面脓液菌种分布及药敏分析  

Analysis of distribution and drug resistance of bacteria in wound infections of snake-bite suffers

作　　者：余丽阳[1] 杨玮[1] 詹碧翠[1] 

机构地区：[1]杭州市中医院检验科,浙江杭州310006

出　　处：《中国卫生检验杂志》2014年第13期1964-1966,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的了解我院近5年来蛇咬伤患者创面感染的菌种分布及耐药性,为临床合理用药提供依据。方法对我院2009年1月-2013年12月皮肤科门诊和住院患者的蛇伤创面脓液标本分离到的细菌采用VITEK 2 Compact系统进行鉴定和药敏,药敏数据用WHONET 5.4软件进行分析。结果 329份创面标本中有89例阳性标本,阳性率27.1%,其中有7例为混合菌感染。菌种分布中,居前3位的分别为金黄色葡萄球菌(21.9%、21/96)、摩根摩根菌(14.6%、14/96)、肺炎克雷伯菌(10.4%、10/96)。药敏结果显示:金黄色葡萄球菌对莫沙西星、喹奴普汀-达福普汀、利柰唑烷、万古霉素、替加环素、呋喃坦因未出现耐药,其中检出MRSA4株,占19.0%。摩根摩根菌对大多数抗生素均敏感。肺炎克雷伯菌对头孢替坦和亚胺培南为100%敏感,其中产ESBLs的菌株占40%(4/10)。结论蛇咬伤患者创面脓液标本中分离的细菌以金黄色葡萄球菌、摩根摩根菌和肺炎克雷伯菌为主;药敏试验指导临床合理使用抗生素。Objective To investigate the species distribution and drug resistance of the snake-bite wound infection in the hospital in the past 5 years,so as to guide rational use of antibiotics in clinic.Methods From January 2009 to December 2013,the bacteria were isolated from snake-bite wound infections of the outpatients and inpatients in the dermatology department for identification and drug sensitivity test by VITEK 2 Compact system.WHONET5.4 soft ware was used to analyze the drug sensitivity data.Results Eighty-nine positive specimens were found in 329 wound infection samples,the positive rate was27.1%,and 7 samples were mixed infection.Staphylococcus aureus（21.9%,21/96）,Morganella morganii（14.6%,14/96）and klebsiella pneumonia（10.4%,10/96） ranked the top three among all the bacteria.The drug sensitivity test results showed that no Staphylococcus aureus strain was found resistant to moxifloxacin,vancomycin,quinupristin-dalfopristin,linezolid,tigecycline,nitrofurantoin,and there were 4 MRSA strains（19.0%）.All the Morganella morganii were sensitive to most of the antibiotics.All the klebsiella pneumonia isolates were sensitive to cefotetan and imipenem,and 40% of the strains were found producing ESBLs（4/10）.Conclusion The bacteria isolated from snake-bite wound were mainly Staphylococcus aureus,Morganella morganii,klebsiella pneumonia.Drug sensitivity test can guide reasonable use of clinical antibiotics.

关 键 词：蛇咬伤 创面脓液 菌种分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]