骨科患者感染的病原菌分布与耐药性研究  

Distribution and drug resistance of pathogens for orthopedic infections

作　　者：毛唯[1] 杨钟华[1] 梁胜西 

机构地区：[1]武汉市普爱医院骨科,湖北武汉430000

出　　处：《中华医院感染学杂志》2015年第7期1524-1526,共3页Chinese Journal of Nosocomiology

基　　金：湖北省自然科学基金资助项目(2003ABA161)

摘　　要：目的掌握医院骨科患者感染病原菌分布,降低和减少骨科患者发生感染的危险性,为临床治疗中抗菌药物的合理使用提供指导。方法选取2011年3月-2013年9月骨科病房患者1 000例作为观察对象,对患者伤口分泌物进行收集,严格无菌操作并立即送检,参考《全国临床检验操作规程》对患者送检的痰液、尿液、伤口渗出液等标本进行细菌分离培养纯化,对病原菌的检测和耐药性分析通过全自动微生物鉴定仪和K-B试验法进行,采用SPSS19.0进行统计分析。结果调查1 000例患者中共348例发生感染,感染率为34.80%;分离出426株病原菌,以革兰阴性菌为主,240株占56.34%;大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌对美罗培南和亚胺培南均无耐药菌检出,对青霉素类抗菌药物耐药率最高。结论骨科感染的影响因素多,不同细菌对同种抗菌药物的敏感性差异很大,因此应严格按照细菌培养结果和耐药试验结果合理应用抗菌药物,降低骨科患者感染率。OBJECTIVE To understand the distribution of pathogens for orthopedic infections and reduce the risk of infections so as to provide guidance for the rational use of antimicrobial drugs during treatment.METHODS Totally 1000 patients in the orthopedic ward during Mar.2011 to Sep.2013 were enrolled as the observed subjects.The patient wound secretions were collected in accordance with strict aseptic operation and were immediately inspected.The bacteria were isolated,cultured and purified from specimens of sputum,urine,wound exudate,etc.with reference to the National Clinical Laboratory Procedures.The detection and resistance analysis of pathogens was performed with the automated microbial identification system and the KB test.The software SPSS19.0was used for statistical analysis.RESULTS Totally 348 out of 1000 cases had infections,the infection rate was34.80%.A total of 426 pathogens were detected,mainly including gram-negative bacteria（56.34%）.No meropenem or imipenem-resistant strains of Escherichia coli,Klebsiella pneumoniae,and Acinetobacter baumannii were detected,while the resistance of these pathogens was the highest to penicillins.CONCLUSION Various factors influence orthopedic infections and there are large differences in sensitivities between different bacteria to antimicrobial drugs.Therefore,clinicians should rationally use antimicrobial drugs in strict accordance with the results of bacterial culture and drug test so as to reduce infection rates of orthopedic patients.

关 键 词：骨科 感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]