整形外科常见病原菌的耐药性分析

Analysis of antibiotic resistance of common bacteria in platsic surgery

目的 研究整形外科感染的常见病原菌及其对常用抗生素的耐药性 ,以指导临床用药。方法 采用Vitek -AmsSystem法和Kirby -Bauer法 ,对整形外科临床标本进行细菌培养并检测其对多种抗生素的耐药性。 结果 分离得到 2 91株致病菌 ,位列前 5位的分别是大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、表皮葡萄球菌、克雷伯菌属。革兰氏阴性杆菌对第 3代头孢菌素的耐药性较高 ,可能与产超广谱 β内酰胺酶菌株的增多有关 ,亚胺培南是治疗革兰氏阴性杆菌感染最有效的药物 ;金黄色葡萄球菌对常用抗生素的耐药百分数超过 70 % ,层析万古霉素仍然是治疗革兰氏阳性球菌感染的最有效药物。结论 开展细菌耐药性的监测对整形外科临床抗生素的合理应用 ,提高现有抗生素的疗效 ,减缓耐药菌株的发生与发展有重要意义。

Objective To study the common pathogens in plastic surgical infection and their resistance to antibiotics in order to guide the clinical drug application. Methods Vitek-Ams system and Kirby-Bauer method were used to examine the antibiotics resistance of isolated bacteria from plastic surgical wards. Results 291 strains were isolated. The first five common strains were escherichia coil; pseudomonas aeruginosa; staphylococcus aureus; staphylococcus epidermidis; klebsiela sp. Gram-negative coil had higher resistance against the 3rd generation of cephalosporins and it might be the result of increasing of extended spectrum β lactamases. Imipenem was most effective to the Gram-negative. The resistance to common antibiotics of staphylococcus aureus was more than 70%, vancomycin was still effective to the Gram-positive coccus. Conclusion The results suggest that the surveillance of antibiotics resistance is important to improve the effect of antibiotics and to reduce the occurrence of antibiotics resistance of bacteria.