创伤性骨折感染创面分泌物病原菌分布调查及相关耐药性分析  

Investigation on distribution of pathogenic bacteria in wounds of traumatic fracture infection and analysis of related drug resistance

作　　者：王红霞[1] 王晓怀 邱燕芬[1] Wang Hongxia;Wang Xiaohuai;Qiu Yanfen(Department of Clinical Laboratory,Hangzhou Plastic Surgery Hospital,Hangzhou 310000,China;Department of Clinical Laboratory, Zhejiang Armed Police Corps Hospital)

机构地区：[1]杭州整形医院检验科,310000 [2]武警浙江总队医院检验科

出　　处：《中国医院统计》2019年第5期359-362,共4页Chinese Journal of Hospital Statistics

摘　　要：目的研究创伤性骨折感染创面分泌物病原菌的分布情况及相关耐药性,以期为临床合理应用抗菌药物提供指导。方法将2017年7月至2018年10月期间于某院接受诊治的3154例创伤性骨折并发创面感染患者作为观察对象,对患者的一般资料进行收集,并对感染创面分泌物内病原菌分布、耐药性进行分析。结果3154例创伤性骨折感染创面分泌物中共分离出病原菌3154株。其中革兰阳性菌共检出2129株(67.5%),主要为金黄色葡萄球菌、表皮葡萄球菌;革兰阴性菌共检出984株(31.2%),主要为大肠埃希菌、阴沟肠杆菌。金黄色葡萄球菌、表皮葡萄球菌对利奈唑胺、氨苄西林、替加环素及呋喃妥因存在高度敏感性,耐药率均为0.0%,且表皮葡萄球菌对环丙沙星存在高度敏感性,耐药率是0.0%,但金黄色葡萄球菌、表皮葡萄球菌对青霉素耐药率均为100%,同时金黄色葡萄球菌、表皮葡萄球菌对其他抗菌药物的耐药率均<50%。大肠埃希菌对头孢唑啉、氨苄西林、舒巴坦、头孢曲松、超广谱β-内酰胺酶、左氧氟沙星的耐药性均>70%,但对红霉素及亚胺硫霉素、哌拉西林、丁胺卡那霉素、厄他培南无耐药性,而阴沟肠杆菌对亚胺硫霉素无耐药性,但对其他15种抗菌药物的耐药率均>20%。结论创伤性骨折感染创面分泌物病原菌分布以金黄色葡萄球菌、表皮葡萄球菌等革兰阳性菌为主,临床治疗需根据耐药性分析结果合理选择抗菌药物,避免感染暴发流行。Objective To study the distribution of pathogenic bacteria in wounds of traumatic fractures and related drug resistance,in order to provide guidance for the rational application of antibacterial drugs.Methods Totally 3154 patients with traumatic fracture complicated with wound infection treated in our hospital from July 2017 to October 2018 were observed in this study.The general data of the patients were collected,and the distribution and drug resistance of pathogenic bacteria in the wounds of infected wounds were analyzed.Results A total of 3154 pathogenic bacteria were isolated from infected wounds in 3154 cases with traumatic fractures.Among them,2129 cases of strains(67.5%)were detected gram-positive bacteria,mainly staphylococcus aureus and staphylococcus epidermidis,and 984 cases of strains(31.2%)were detected gram-negative bacteria,mainly Escherichia coli and Enterobacter cloacae.The Staphylococcus aureus and Staphylococcus epidermidis were highly sensitive to linezolid,ampicillin,tigecycline and nitrofurantoin,and the drug resistance rate was 0.0%.And Staphylococcus epidermidis was highly sensitive to ciprofloxacin,and the drug resistance rate was 0.0%.However,the resistance rate of Staphylococcus aureus and Staphylococcus epidermidis to penicillin was 100%.At the same time,the resistance rates of Staphylococcus aureus and Staphylococcus epidermidis to other antibiotics were under 50%.Escherichia coli resistance to cefazolin,ampicillin,sulbactam,ceftriaxone,extended-spectrumβ-lactamase,levofloxacin was over 70%,but for erythromycin and imipenem,Piperacillin,amikacin,ertapenem it was non-resistant.Enterobacter cloacae was not resistant to imipenem,but the resistance rate to other 15 antibacterial drugs was over 20%.Conclusion The distribution of pathogenic bacteria in wounds of traumatic fractures is mainly gram-positive bacteria such as Staphylococcus aureus and Staphylococcus epidermidis.The clinical treatment needs to select antibiotics according to the results of drug resistance analysis to avoid the

关 键 词：创伤性骨折 感染创面 分泌物病原菌 耐药性 抗菌药物 

分 类 号：R195.4[医药卫生—卫生统计学] R639[医药卫生—卫生事业管理]