骨科创伤患者感染病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens in orthopedic trauma patients

作　　者：李鹏[1] 韩小松[1] 王世强[1] 向丙彦 夏本杰[1] 柏帆[1] 

机构地区：[1]遵义市第一人民医院骨科,贵州遵义563000

出　　处：《中华医院感染学杂志》2017年第21期4957-4959,5033,共4页Chinese Journal of Nosocomiology

摘　　要：目的回顾性观察骨科创伤患者感染病原菌分布情况及耐药性特点,为临床合理选取抗菌药物提供参考依据。方法选取2013年6月-2016年5月医院骨科创伤患者1196例,分析其感染患者病原菌分布及耐药率。结果 1 196例骨科创伤,感染率为2.01%;24例感染患者共分离病原菌36株,其中革兰阴性菌25株占69.44%,高于革兰阳性菌的27.78%、真菌的2.78%,差异有统计学意义(P<0.05);铜绿假单胞菌对头孢唑林、头孢西丁耐药率均达100.00%,大肠埃希菌及肺炎克雷伯菌对氨苄西林、头孢唑林、头孢西丁耐药率达100.00%,鲍氏不动杆菌对头孢唑林、头孢西丁、呋喃妥因耐药率为100.00%,阴沟肠杆菌对头孢唑林和头孢西丁耐药率达100.00%,金黄色葡萄球菌、表皮葡萄球菌对青霉素G、苯唑西林耐药率均为100.00%。结论骨科创伤患者感染后尽快采集标本实施病原菌培养及鉴定,严格遵循药敏试验结果及时调整抗菌药物,避免耐药菌产生。OBJECTIVE To retrospectively analyze the distribution and drug resistance of pathogenic bacteria in orthopedic trauma patients,so as to provide bacteriological reference for rational selection of antimicrobial agents.METHODS A total of 1196 cases of orthopedic trauma patients were selected from Jun.2013 to May 2016,and the distribution and drug resistance of pathogens were analyzed.RESULTS Among 1196 cases of orthopedic trauma patients,24 patients infected,and the infection rate was 2.01%.Totally 36 strains of pathogens were isolated,and25 strains were gram-negative bacteria,accounting for 69.44%,which was significantly higher than that of grampositive bacteria（27.78%）and fungi（2.78%）（P〈0.05）.The resistant rates of Pseudomonas aeruginosato cefazolin and cefoxidin were 100.00%,Escherichia coli to ampicillin,cefazolin and cefoxitin were 100.00%,Acinetobacter baumannii to cefazolin,cefoxitin and nitrofurantoin were 100.00%,Enterobacter cloacae to cefazolin and cefoxitin were 100.00%,and Staphylococcus aureus and Staphylococcus epidermidis to penicillin G and oxacillin were 100.00%.CONCLUSION We should collect specimens as soon as possible,carry out the pathogenic bacteria culture and identification in orthopedic trauma patients after infections,strictly follow the drug sensitivity test results to timely adjust antibiotics,so as to avoid the emergence of drug-resistant bacteria.

关 键 词：骨科 创伤 感染 病原菌 耐药 

分 类 号：R681.2[医药卫生—骨科学]