开放性骨折患者创口感染的病原菌分布及抗感染治疗分析  

Distribution of pathogens causing wound infections in patients with wound infection and anti-infection treatment

作　　者：裘情密[1] 沈健健[1] 施绒舟[1] 陈仲夷[1] 许凌华[1] 

机构地区：[1]慈溪市人民医院骨科,浙江慈溪315300

出　　处：《中华医院感染学杂志》2017年第6期1325-1328,共4页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金资助项目(S201102002426)

摘　　要：目的探究开放性骨折患者创口感染后的病原菌分布以及对患者进行抗感染治疗的情况,为开放性骨折患者的相关治疗提供可以借鉴的临床依据。方法选择医院2012年3月-2016年3月收治的开放性骨折患者70例,采集患者创口标本进行病原菌的培养、分离,对病原菌的分布进行统计,并进行耐药试验。结果 70例患者送检的标本共分离出病原菌75株,其中革兰阳性菌27株占36.0%,以金黄色葡萄球菌13株为主占17.3%,革兰阴性菌48株占64.0%,以阴沟肠杆菌19株为主占25.3%,检测显示分离出的革兰阳性菌中,金黄色葡萄球菌对利福平的敏感率最高为100.0%,对氨苄西林的敏感率最低为38.4%,粪肠球菌对氨苄西林的敏感率最高为100.0%,对头孢曲松的敏感率最低为0,表皮葡萄球菌对环丙沙星的敏感率最高为50.0%,对头孢曲松的敏感率最低为10.0%,分离出的革兰阴性菌中,鲍氏不动杆菌对美罗培南的敏感率最高为100.0%,对头孢曲松的敏感率最低为50.0%,铜绿假单胞菌对哌拉西林的敏感率最高为87.5%,对头孢曲松的敏感率最低为37.5%,大肠埃希菌对美罗培南的敏感率最高为100.0%,对头孢曲松以及哌拉西林的敏感率最低均为50.0%,阴沟肠杆菌对美罗培南的敏感率最高为100.0%,对洛美沙星以及哌拉西林的敏感率最低均为68.4%。结论造成开放性骨折患者创口感染的病原菌以革兰阴性菌为主,并且常规药物对于病原菌的抑制效果较低,因此在对患者治疗的过程中根据患者感染情况对症用药,以取得良好的治疗效果。OBJECTIVE To explore the distribution of pathogens causing wound infection in patients with open frac-ture and analyze the anti-infection treatment of the patients so as to provide clinical basis for related treatment of the patients with open fracture .METHODS A total of 70 patients with open fracture who were treated in the hospi-tal from Mar 2012 to Mar 2016 were enrolled in the study ,then the wound specimens were collected from the pa-tients for culture and isolation of pathogens ,the distribution of the pathogens was statistically analyzed ,and the drug susceptibility testing was performed .RESULTS Totally 70 strains of pathogens were isolated from the sub-mitted specimens that were obtained from the 70 patients ,including 27 （38 .6% ） strains of gram-positive bacteria and 43 （61 .4% ） strains of gram-negative bacteria ;Staphylococcus aureus was dominant among the gram-positive bacteria ,accounting for 18 .6% ;Enterobacter cloacae was the predominant species of gram-negative bacteria ,ac-counting for 27 .1% .The drug susceptibility testing showed that among the isolated gram-positive bacteria ,the drug susceptibility rate of S .aureus strains to rifampicin was the highest （100 .0% ）;the drug susceptibility rate to ampicillin was the lowest （38 .4% ）;the drug susceptibility rate of Enterococcus f aecalis to ampicillin was the highest （100 .0% ）;the drug susceptibility rate to ceftriaxone was lowest （0 .0% ）;the drug susceptibility rate of Staphy-lococcus epidermidis to ciprofloxacin was the highsest （50 .0% ）;the drug susceptibility rate to ceftriaxone was the lowest （10 .0% ） . Among the isolated gram-negative bacteria , the drug susceptibility rate of Acinetobacter baumannii to meropenem was the highest （100 .0% ） ;the drug susceptibility rate to ceftriaxone was the lowest （50 .0% ）;the drug susceptibility rate of P seudomonas aeruginosa to piperacillin was the highest （87 .5% ）;the drug susceptibili-ty rate to ceftriaxone was the lowest （37 .5% ）;the drug su

关 键 词：开放性骨折 病原菌 抗感染 

分 类 号：R378[医药卫生—病原生物学]