骨外科老年感染患者的病原菌分布及耐药监测

Distribution and antimicrobial resistance of bacteria from orthopaedic elderly patients

目的了解我院骨科老年感染患者常见病原菌的分布情况及耐药率,从而指导临床合理应用抗菌药物。方法收集我院骨科病房老年患者339例,采集病灶伤口分泌物等标本进行细菌培养鉴定,并对检出的病原菌按照K-B法进行药敏实验。结果骨外科老年感染患者分离细菌337株,革兰阴性菌153株(45.4%),主要包括大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌等。革兰阳性菌175株(51 9%),主要包括金黄色葡萄球菌、表皮葡萄球菌、粪肠球菌等。真菌9株(2.7%)。药敏结果显示耐药菌株多,耐药情况复杂,革兰阳性菌和阴性菌均对青霉素类抗生素耐药率较高。万古霉素和亚胺培南分别是革兰阳性菌和革兰阴性菌敏感性较高的抗菌药物。结论医院感染病原菌的构成及耐药谱不断发生着变化,严格根据病原菌的鉴定及耐药性的监测结果应用抗生素药物,可以有效减少骨科老年患者的感染率。

Objective To understand the distribution and antimicrobial resistance from orthopaedic elderly patients,and provide guidance on the application of antimicrobial drugs reasonably.Methods A total of 339 elderly patients from orthopaedic department were selected.The samples from the secreations of lesions and wound were cultured,and the pathogenic bacteria were identified.The drug susceptibility and resistance detection were performed by the K—B method.Results 337 pathogenic trains were detected from orthopedic elderly patients.Of which,153(45.4%)were gram-negative bacterium including Escherichia coli,Pseudomonas aeruginosa,Acinetobacter baumannii,175(51.9%) were gram—positive bacterium including Staphylococcus aureus, Staphylococcus epidermidis,Intestinal coccu,and 9(2.7%) were Fungi.Drug susceptibility test showed multi—drug—resistant strains.Gram—positive and gram—negative bacteria all had higher resistance to penicillin antibiotics.Vancomycin had higher sensitivity to gram—positive bacteria and imipenem had higher sensitivity to gram—negative bacteria.Conclusion The composition of pathogenic bacteria and drug resistance spectrum changed constandy in hospital.It could reduce the infection of orthopaedic elderly patients to use antibiotic drugs in accordance with the identification of pathogenic bacteria and suveillance of drug resistance.