骨科患者术后医院感染病原菌分布与耐药性  

Distribution and drug resistance of pathogens causing postoperative nosocomial infections in patients of department of orthopedics

作　　者：杨志勇[1] 王开明[1] 郑延贵[1] 冯磊[1] 李甲[1] 

机构地区：[1]蚌埠市第三人民医院骨科,安徽蚌埠233000

出　　处：《中华医院感染学杂志》2015年第12期2723-2725,共3页Chinese Journal of Nosocomiology

基　　金：安徽省蚌埠市科技局基金资助项目(20140328)

摘　　要：目的探讨骨科患者术后医院感染病原菌分布及其耐药性,为临床抗菌药物应用提供依据。方法选择2011年4月-2014年12月于医院择期行手术治疗的1 472例骨折患者为研究对象,调查分析患者医院感染率、感染部位、感染病原菌种类及其耐药性,调查数据统计分析采用Excel 2007软件进行。结果 1 472例患者发生医院感染42例,感染率为2.9%;感染部位以下呼吸道、皮肤及黏膜组织、胃肠道为主,分别占35.7%、28.6%、14.3%;共分离出病原菌76株,其中革兰阳性菌31株占40.8%,革兰阴性菌45株占59.2%;革兰阳性菌中金黄色葡萄球菌及屎肠球菌对头孢唑林、头孢哌酮、氨苄西林、苯唑西林、青霉素G的耐药率均>60.0%,革兰阴性菌中铜绿假单胞菌及肺炎克伯菌对头孢他啶、头孢哌酮、氨苄西林和阿莫西林的耐药率均>45.0%。结论骨科患者术后医院感染病原菌以革兰阴性菌为主,临床应加强病原菌监测,掌握感染病原菌分布及其耐药性,对患者的预后具有重要意义。OBJECTIVE To explore the distribution and drug resistance of the pathogens causing postoperative nosocomial infections in the patients of department of orthopedics so as to provide guidance for clinical use of anti‐biotics .METHODS A total of 1 472 fracture patients who underwent the selective surgery from Apr 2011 to Dec 2014 were recruited as the study objects ,then the incidence of nosocomial infections ,infection sites ,and distribu‐tion and drug resistance of the pathogens were investigated ,and the statistical analysis of data was performed with the use of Excel 2007 software .RESULTS The nosocomial infections occurred in 42 of 1 472 patients with the in‐fection rate of 2 .9% ,of whom 35 .7% had the lower respiratory tract infections ,28 .6% had the skin and mucosa infections ,and 14 .3% had the gastrointestinal tract infections .Totally 76 strains of pathogens have been isolated , including 31 （40 .8% ） strains of gram‐positive bacteria and 45 （59 .2% ） strains of gram‐negative bacteria .Among the gram‐positive bacteria ,the drug resistance rates of the Staphylococcus aureus and Enterococcus f aecium to ce‐fazolin ,cefoperazone ,ampicillin ,oxacillin ,and penicillin G were more than 60 .0% .Among the gram‐negative bacteria ,the drug resistance rates of the Pseudomonas aeruginosa and K lebsiella pneumoniae to ceftazidime ,cef‐operazone ,ampicillin ,and amoxicillin were more than 45 .0% .CONCLUSIONS The gram‐negative bacteria are dominant among the pathogens causing the postoperative nosocomial infections in the patients of department of or‐thopedics .It is of great significance to strengthen the surveillance of the pathogens and understand the distribution and drug resistance of the pathogens causing the infections so as to improve the prognosis of the patients .

关 键 词：骨科 医院感染 病原菌 

分 类 号：R378[医药卫生—病原生物学]