人工关节置换患者术后感染病原菌分布与耐药性分析  

The distribution and drug resistance of pathogens in patients with hospital infections after artificial joint replacement

作　　者：龚江浩[1] 蔡航[1] 鲍丰[1] 陈旭宏[1] 

机构地区：[1]温州医科大学附属义乌医院骨一科,浙江温州322000

出　　处：《中华医院感染学杂志》2015年第11期2440-2441,2449,共3页Chinese Journal of Nosocomiology

基　　金：浙江医药卫生研究基金资助项目(2013KYB175)

摘　　要：目的探讨人工关节置换术后患者医院感染病原菌分布及耐药性,为临床预防治疗人工关节置换术后医院感染提供依据。方法回顾性分析2010年1月-2014年1月638例行人工关节置换术患者临床资料,其中62例行人工关节置换术并发感染,对人工关节置换术后患者医院感染发生率、病原菌分布及其耐药性进行统计。结果 638例行人工关节置换术患者发生医院感染62例,感染率9.72%;共分离鉴定病原菌75株,其中革兰阴性菌45株占60.00%、革兰阳性菌30株占40.00%;大肠埃希菌对常用抗菌药物高度耐药,对头孢呋辛耐药率高达100.00%,凝固酶阴性葡萄球菌对阿米卡星、红霉素、青霉素和克林霉素高度耐药,耐药率分别为72.73%、90.91%、81.82%和72.73%;金黄色葡萄球菌对阿米卡星、克林霉素和青霉素高度耐药,耐药率分别为62.50%、75.00%和100.00%。结论人工关节置换术后医院感染的主要革兰阴性菌为大肠埃希菌和铜绿假单胞菌,主要革兰阳性菌为凝固酶阴性葡萄球菌和金黄色葡萄球菌,其对多种抗菌药物高度耐药,应做好药敏试验,指导临床合理选用抗菌药物,预防和减少耐药菌株产生。OBJECTIVE To investigate the distribution and drug resistance of pathogens in patients with hospital infections after artificial joint replacement , and to provide the basis for clinical prevention and treatment . METHODS The clinical data of 62 patients with hospital infections after artificial joint replacement treated in our hospital from Jan .2010 to Jan .2014 were retrospectively analyzed .The hospital infection rate ,the distribution and drug resistance of pathogens were investigated .RESULTS There were 62 cases of hospital infection in the 638 patients with the infection rate of 9 .72% .Totally 75 strains were identified ,including 45 strains of gram‐negative bacteria （60 .00% ） and 30 strains of gram‐positive bacteria （40 .00% ） .Escherichia coli were highly resistant to most common antibiotics ,and the resistant rate to cefuroxime was up to 100% .Coagulase negative Staphylococci showed high drug resistance to amikacin （72 .73% ） ,erythromycin （90 .91% ） ,penicillin （81 .82% ） and clindamy‐cin （72 .73% ） . Staphylococcus aureus showed high drug resistance to amikacin （62 .50% ） , clindamycin （75 .00% ） and penicillin （100 .00% ） .CONCLUSION The main gram‐negative bacteria included E .coli and Pseud‐omonas aeruginosa ,and the main gram‐positive bacteria included coagulase negative Staphylococci and S .aureus in patients with hospital infection after artificial joint replacement ,and pathogens were highly resistant to various common antibiotics .Therefore ,it is necessary to conduct drug sensitivity test to guide the clinical rational use of antibiotic drugs ,and to prevent and reduce the drug resistant strains .

关 键 词：人工关节置换术 医院感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]