慢性感染性创面分离的多重耐药菌分布研究  

Study on the distribution of multidrug resistant organisms isolated from chronically infected wounds

作　　者：江琰笛[1] 张勇[1] 陶崑[1] 李情操 朱晶晶 JIANG Yan-di;ZHANG Yong;TAO Kun;LI Qing-cao;ZHU Jing-jing(The Sixth Hospital of Ningbo,Ningbo Zhejiang 315040;Li Huili Eastern Hospital of Ningbo Medical Center,China)

机构地区：[1]浙江省宁波市第六医院,浙江宁波315040 [2]宁波市医疗中心李惠利东部医院

出　　处：《中国消毒学杂志》2020年第8期570-572,共3页Chinese Journal of Disinfection

基　　金：宁波市自然基金项目(2018A610402);浙江省医药卫生科技项目(2019KY609)。

摘　　要：目的研究慢性感染创面分离的多重耐药菌(MDROs)种类分布及其耐药特性,为临床合理用药提供理论依据。方法通过细菌分离鉴定和药敏试验方法,对某医院212例慢性难愈合创面感染分泌物进行检测与分析。结果从212例慢性感染创面分泌物中分离出病原菌122例,检出率为57. 55%。共检出病原菌156株,其中多重耐药菌102株,占分离菌株总数的65. 39%。102株多重耐药菌中,包括革兰阳性菌25株和革兰阴性菌77株;居前4位依次是产ESBLs大肠埃希菌、多重耐药铜绿假单胞菌、产ESBLs奇异变形杆菌和耐甲氧西林金黄色葡萄球菌(MASA),构成比依次为21. 57%、17. 65%、13. 73%和11. 76%。MDROs仅对万古霉素和美罗培南有较好的敏感性。结论慢性感染创面感染菌多为MDROs,以革兰阴性菌为主,提示应加强创面感染病原菌监测,合理选用抗菌药物。Objective To study the distribution and drug resistance characteristics of multidrug resistant organisms( MDROs) isolated from chronically infected wounds,so as to provide a theoretical basis for clinical rational use of drugs.Methods Through bacterial isolation and identification and drug susceptibility testing methods,212 cases of infected secretions from chronic non-healing wounds in a hospital were detected and analyzed. Results 122 pathogenic bacteria were isolated from 212 cases of secretions from chronically infected wounds,with a detection rate of 57. 55%. A total of 156 strains of pathogenic bacteria were detected,of which 102 strains were MDROs,accounting for 65. 39% of the total number of isolates. 102 strains of MDROs included 25 strains of Gram-positive bacteria and 77 strains of Gram-negative bacteria;the top four were ESBLs-producing Escherichia coli and multidrug-resistant Pseudomonas aeruginosa,ESBLs-producing Proteus mirabilis and methicillin-resistant Staphylococcus aureus( MASA),with a composition ratio of 21. 57%,17. 65%,13. 73% and 11. 76%,respectively. MDROs were only sensitive to vancomycin and meropenem. Conclusion Most of infectious bacteria from chronically infected wounds are MDROs,which are mainly Gram-negative bacteria,suggesting that the monitoring of pathogenic bacteria of wound infection should be strengthened and antibacterial drugs should be rationally selected.

关 键 词：慢性感染创面 多重耐药菌 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]