脊柱后路内固定植骨融合术后深部感染病原菌与耐药性分析  

Pathogenic bacteria and analysis of drug resistance of deep infections after posterior spinal fixation and fusion

作　　者：张楠[1] 周永焘[1] 郗政[1] 刘金煜[1] 

机构地区：[1]齐齐哈尔医学院附属第二医院骨外科,黑龙江齐齐哈尔161000

出　　处：《中华医院感染学杂志》2015年第12期2720-2722,共3页Chinese Journal of Nosocomiology

基　　金：黑龙江省卫生厅规划基金资助项目(HW-2010B030)

摘　　要：目的：探讨脊柱后路内固定植骨融合术后切口深部感染病原菌分布及耐药性，以期提高临床治疗水平。方法随机选取2005年3月－2013年3月1315例脊柱后路内固定植骨融合术患者为研究对象，对其中出现切口深部感染的55例患者进行病原菌和耐药性分析，数据采用PPM S软件进行统计分析。结果1315例患者中发生切口感染55例，感染率为4．18％；55例感染患者共培养出病原菌66株，其中革兰阴性菌37株占56．06％、革兰阳性菌29株占43．94％，革兰阴性菌中以鲍氏不动杆菌、肺炎克雷伯菌、变形菌属为主，而革兰阳性菌中主要病原菌为金黄色葡萄球菌和表皮葡萄球菌；常见革兰阴性菌对青霉素 G 的耐药率最高，为90．91％～100．00％，对利福平、米诺环素的耐药率最低，为0～11．11％，常见革兰阳性菌对美罗培南、亚胺培南的耐药率均为0，对其他抗菌药物的耐药率均较高为28．57％～100．00％。结论脊柱后路内固定植骨融合术后切口深部感染病原菌较复杂，在临床上要加强细菌培养和药敏试验，应用敏感抗菌药物。OBJECTIVE To investigate distribution and drug resistance of pathogens for deep incision infections after the posterior spinal fixation and fusion ,so as to improve the level of clinical treatment .METHODS Totally 1 315 cases undergoing posterior spinal fixation and fusion during Mar .2005 to Mar .2013 were randomly selected . Among these cases ,55 patients who developed deep incision infection were analyzed for pathogens and drug resistance .The PPMS software was used for statistical analysis of data .RESULTS Totally 55 out of 1 315 patients had incision infections with the infection rate of 4 .18% .A total of 66 bacteria were cultured from these 55 cases , including 37 gram‐negative bacteria accounting for 56 .06% and 29 gram‐positive bacteria accounting for 43 .94% . The gram‐negative bacteria mainly included Acinetobacter baumannii ,Klebsiella pneumoniae ,and Proteus haus‐er .The gram‐positive bacteria mainly included Staphylococcus aureus and Staphylococcus epidermidis . The common gram‐negative bacteria had the highest resistance of 90 .91% -100 .00% to penicillin G and the lowest resistance of 0 -11 .11% to rifampin and minocycline .The common gram‐positive bacteria had 0 resistance to meropenem and imipenem and relatively high resistance of 28 .57% -100 .00% to other antibacterial agents . CONCLUSION The pathogens for deep incision infection after posterior spinal fixation and fusion are complex . Clinicians should enhance the clinical bacterial culture and sensitivity test and apply sensitive antibacterial agents .

关 键 词：脊柱内固定术后 切口深部感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]