外科感染性标本的病原菌分析

Pathogens in Surgically Infective Specimen:An Analysis

目的探讨医院外科感染性标本的病原菌分布及耐药性，指导临床合理选择抗感染药物。方法采集感染性标本进行细菌培养，采用常规方法分离病原菌并进行鉴定；用琼脂扩散法（K—B法）进行药物敏感试验。结果322株外科感染性标本分离的病原菌中，金黄色葡萄球菌（SAU）、大肠埃希菌（ECO）、铜绿假单胞菌（PAE），分别占第1、2、3位，占总数的25．2％、15．8％、13．0％；耐甲氧西林金黄色葡萄球菌（MRSA）检出率为32．1％；耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）检出率为33．3％；产ESBLs大肠埃希菌和肺炎克雷伯菌检出率为34．5％；各种病原菌均产生了不同程度的耐药性，但万古霉素对革兰阳性球菌敏感率为100．0％；亚胺培南对革兰阴性杆菌敏感率为19．0％～100．0％。结论外科感染病原菌耐药性各异，临床应根据细菌培养的结果合理使用抗菌药物，避免耐药菌产生与流行。

OBJECTIVE To study the distribution and drug-resistance status of pathogens in surgically infective specimen in Renmin Hospital of Qichun County and provide the reference for clinically reasonable use of antibiotics. METHODS The infective specimen were collected to perform bacterial culture. The routine methods were adopted to identify pathogenic bacterium. Susceptibility testing was performed by K-B method. RESULTS Among 322 strains from surgically infective specimen, Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa, ranking the top three, accounted for 25.2%, 15.8% and 13.0%, respectively. The detection rate of meticillin-resistant S. aureus （MRSA） was 32.1%. And that of metidllin-resistant coagulase negative Staphylococcus （MRCNS） was 33.3 %. That of extended spectrum β-lactamases （ESBLs） producer in E. coli and Klebsiella pneumoniae was 34.5%. Various pathogenic bacterium had been resistant to antibiotics to different extents. 100.0% of Gram-positive cocci were sensitive to vancomycin. The sensitivity rate to imipenem in Gram-negative bacilli was 19. 0- 100. 0%. CONCLUSIONS Drug resistance variesd from pathogenic bacterium in surgical infection. The clinician should reasonably choose antibiotics according to results of bacterial culture to avoid occurrence and prevalence of drug-resistance bacterium.