骨科开放性伤口厌氧菌感染的临床和病原学特点  

Clinical and etiological characteristics of anaerobic infection in open wounds of orthopedic patients

作　　者：宋萍萍 刘颖[1] 吴俊[1] 梁倩 王艳[1] SONG Pingping;LIU Ying;WU Jun;LIANG Qian;WANG Yan(Medical Laboratory Center,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院医学检验中心,北京100035

出　　处：《中国感染与化疗杂志》2022年第6期675-679,共5页Chinese Journal of Infection and Chemotherapy

基　　金：北京积水潭医院“学科骨干”计划专项经费(XKGG 202125)。

摘　　要：目的分析骨科开放性伤口厌氧菌感染的临床特征和病原学特点,为厌氧菌感染的诊断和治疗提供依据与方向。方法回顾性分析2015年1月—2019年12月北京积水潭医院收治的85例开放性伤口厌氧菌感染患者的临床特征、病原学结果及抗菌药物敏感性。结果男性和中老年患者是开放性伤口厌氧菌感染的主要群体;厌氧菌和(或)需氧菌混合感染率为75.2%。共检出112株厌氧菌,其中梭菌属占24.1%,普雷沃菌属占16.9%,拟杆菌属占12.5%,消化链球菌属占12.5%。上述四种分离菌对哌拉西林-他唑巴坦和美罗培南的敏感率均为100%。结论厌氧菌是引起骨科开放性伤口感染的重要病原菌,临床应重视骨科患者伤口标本的厌氧菌培养,提高治疗效果。Objective To analyze the clinical and etiological characteristics of anaerobic infections in open wounds of orthopedic patients and to provide evidence for the diagnosis and appropriate treatment.Methods A retrospective analysis was conducted with the clinical characteristics,etiological results and antimicrobial susceptibility of 85 cases of anaerobic infection in open wounds.The patients were treated in Beijing Jishuitan Hospital from Janaury 2015 to December 2019.Results Most patients were middle-aged males.The infections were largely polymicrobial caused by both aerobic and anaerobic bacteria,accounting for 75.2%of the cases.A total of 112 strains of anaerobic bacteria were isolated from open wound specimens.The most common anaerobic pathogen was Clostridia(24.1%),followed by Prevotella(16.9%),Bacteroides(12.5%)and Peptostreptococcus(12.5%).In vitro antimicrobial susceptibility testing showed that all of the four genera of anaerobic isolates were 100%susceptible to piperacillin-tazobactam and meropenem.Conclusions Anaerobes are the major pathogens of the open wound infections in orthopedic patients.It is necessary to perform anaerobic cultures in patients with open wound infections for appropriate patient care to avoid treatment failure.

关 键 词：开放性伤口 骨科 厌氧菌 感染 耐药性 

分 类 号：R515.9[医药卫生—内科学]