骨与关节化脓性感染的老年患者菌群分布及抗生素耐药性分析

Analysis of bacterial distribution and antibiotic resistance in bone and joint purulent infection of elderly patients

目的分析骨与关节化脓性感染的病原菌分布及耐药情况,为临床抗生素合理使用提供依据。方法对上饶市人民医院骨外科2009年1月~2013年6月收治514例骨与关节化脓性感染病例菌群分布及药敏试验进行回顾性分析。结果分离革兰阴性菌296株感染率为47.2%,以大肠埃希菌最常见,感染率为15.9%,其次以鲍曼不动杆菌、铜绿假单胞菌多见,感染率分别为11.8%、11.3%;分离革兰阳性菌331株,感染率为52.8%,以表皮葡萄球菌、金黄色葡萄球菌多见,感染率分别为21.5%、13.7%;革兰阴性菌对亚胺培南的敏感性最高,革兰阳性菌对万古霉素敏感。结论革兰阳性菌是骨与关节化脓性感染的主要致病菌,根据药敏试验选择抗生素对临床耐药菌株的治疗有重要的临床意义。

Objective To evaluate the distribution of pathogens causing bone and joint purulent infections and the bacterial resistance to antibiotics,and to provide reference of clinical antibiotic therapy.Methods A total of 514 patients who had bone and joint purulent infections in Department of Orthopedics of Shangrao People’s Hospital from Jan 2009 to Jun 2013 were retrospectively analyzed. Results 296 strains of Gram-negative bacteria were isolated,the infection rate was 47.2%,among which 296 strains of Escherichia coli were the most common infection pathogen,the infection rate was 15.6%,followed by Acinetobacter baumannii,Pseudomonas aeruginosa,and the infection rates were 11.8%,11.3%.331 strains of Gram-positive bacteria were isolated,the infection rate was 52.8%.Staphylococcus epidermidis,Staphylococcus aureus,were the common infection pathogens,following the infection rates were 21.5%,13.7%.Gram-negative bacteria had the highest sensitivity to imipenem,while Gram-positive bacteria had sensitivity to vancomycin.Conclusion Gram-positive bacteria is the main pathogens with bone and joint purulent infections.Selection of antibiotics according to the drug sensitive test has important clinical significance.