创伤病区五年内创口分泌物病原菌分布和耐药性分析  

Distribution and drug resistance of pathogenic bacteria from wound se-cretion of trauma ward in five years

作　　者：王伟[1] 蒋伟燕[2] 贺强贵[1] 方军[1] 陶礼钧[1] 徐洪波[1] 程水兵[1] 包其郁[3] 

机构地区：[1]温州医科大学附属第一医院创伤外科,浙江温州325000 [2]温州医科大学附属第二医院医学检验中心,浙江温州325000 [3]温州医科大学检验医学院与生命科学学院,浙江温州325035

出　　处：《中国现代医生》2015年第25期13-16,F0003,共5页China Modern Doctor

基　　金：浙江省自然科学基金一般项目(LY14C060005)

摘　　要：目的了解创伤病区五年内创口分泌物标本的病原菌分布和耐药情况,为临床合理用药提供依据。方法分析2010~2014年创伤病区送检的747株病原菌。结果 747株病原菌中,革兰阳性菌343株（45.9%）,革兰阴性菌400株（53.5%）,白假丝酵母真菌4株（0.6%）。检出的主要革兰阳性菌为金黄色葡萄球菌,共132株（17.7%）;主要革兰阴性菌为大肠埃希菌,共123株（16.5%）。耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）检出率分别为47.9%和82.7%,未检出对糖肽类中介或耐药的葡萄球菌和肠球菌;大肠埃希菌的ESBLs检出率为58.8%,未检出对亚胺培南耐药的菌株;检出多重耐药的铜绿假单胞菌13株,鲍曼不动杆菌27株。结论创口感染的菌株类型较多,以革兰阴性菌为主,但金黄色葡萄球菌仍为感染的首要细菌;病原菌多重耐药菌较常见,定期进行病原菌分布和耐药情况分析,有助于了解其耐药性变迁,为临床合理用药提供依据。Objective To investigate the distribution and drug resistance of pathogenic bacteria isolated from wound secretion specimens in trauma ward in the past 5 years, and to provide a reasonable basis for application of antimicrobial agents. Methods 747 strains of pathogenic bacteria of trauma ward from 2010 to 2014 were analyzed. Results There were 343 gram-positive bacteria（45.9%）, 400 of gram-negative bacteria（53.5%） and 4 of fungus（0.6%）. The main gram-positive and gram-negative bacteria were S. aureus and E. coli, accounting for 17.7% and 16.5%. MRSA and MRCNS were 47.9% and 82.7%, all the Staphylocuccus and Enterococus were sensitive to glycopeptide antibiotics. ESBLs of E. coli was 58.8%, and there was no imipenem-resistant strain. The multiple drug resistance strains of P. aeruginosa and A.baumannii were 13 and 27. Conclusion Many bacteria can course wound infection. The main bacteria are gram-negative ones, but S. aureus is still the primary pathogen of infection. Multi-resistant bacteria are common. Regular analysis of bacteria distribution and drug resistance helps to know its resistance trends and to provide a reasonable basis for application of antimicrobial agents.

关 键 词：创口 分泌物 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]