感染性创面细菌学调查与药物敏感性分析  

Bacteriological analysis of wound infections and analysis of drug susceptibility

作　　者：窦孝康 程代薇[2] 王毅[2] 

机构地区：[1]黔西南州人民医院普外科,贵州兴义562400 [2]贵州省人民医院烧伤整形科,贵州贵阳550002

出　　处：《中华医院感染学杂志》2015年第21期4858-4860,共3页Chinese Journal of Nosocomiology

基　　金：贵州省科技厅自然科学基金资助项目(20132124)

摘　　要：目的分析感染性创面临床特点与耐药性,以降低耐药菌的产生。方法回顾性分析2010年1月-2012年12月医院整形烧伤科收治的280例慢性感染创面患者临床资料;采用法国生物梅里埃公司VITEK-32型自动微生物检测仪及GNI鉴定卡对分离培养的病原菌予以鉴定,数据采用SPSS17.0软件进行统计分析。结果慢性感染性创面由创伤、术后、烧伤、压疮、糖尿病、血管性疾病引起,分别占47.60%、22.60%、15.41%、6.85%、4.11%、3.43%;所有创面均行病原菌培养,结果均为阳性,共培养出332株病原菌,其中革兰阴性菌228株占68.68%,革兰阳性菌103株占31.02%,真菌1株占0.30%;感染性创面主要以革兰阴性菌为主,对氨苄西林均耐药,对三代头孢菌素抗菌药物耐药率较高,对碳青霉烯类及万古霉素药物敏感性降低。结论创面感染以革兰阴性菌为主,其耐药率较高,抗菌治疗难以愈合,因此在创面感染时,未进行细菌培养前勿滥用抗菌药物,以降低泛耐药菌的产生。OBJECTIVE To investigate the clinical characteristics of the wound infections and analyze the drug resistance so as to prevent the emergence of drug-resistant strains.METHODS The clinical data of 280 patients with chronic wound infections who were treated in the plastic surgery and burn department from Jan 2010 to Dec 2012 were retrospectively analyzed.The isolated pathogens were identified by using VITEK-32 automatic microorganism detection system of bioMerieux,France and GNI identification card,and the statistical analysis of data was performed with the use of SPSS17.0software.RESULTS Of the patients with the chronic wound infections,47.60% had the traumatic wound infections,22.60% had the postoperative wound infections,15.41% had the postoperative wound infections,6.85% had the pressure sores wound infections,4.11% had the diabetic mellitus wound infections,and 3.43% had the vascular wound infections.All the wounds were cultured for pathogens,and the culture results were positive.A total of 332 strains of pathogens were isolated,including 228（68.68%）strains of gram-negative bacteria,103（31.02%）strains of gram-positive bacteria,and 1（0.30%）strain of fungus.The gram-negative bacteria were dominant among the pathogens causing the wound infections and were resistant to ampicillin;the drug resistance rate to the third generation cephalosporins was high,and the drug susceptibility rates to carbapenems and vancomycin were reduced.CONCLUSION The gram-negative bacteria are dominant among the pathogens causing the wound infections and are highly resistant to antibiotics.The wound infections are hardly cured through antibacterial therapy,thus the abuse of antibiotics should be avoided before the bacterial culture so as to prevent the emergence of the drug-resistant strains.

关 键 词：慢性感染创面 病原菌 培养 药敏分析 

分 类 号：R378[医药卫生—病原生物学]