手足创伤患者感染病原菌分布及耐药性分析

Distribution of Pathogens in Patients with Hand and Foot Trauma: Drug Resistance Analysis

目的分析手足创伤患者感染的病原菌及其耐药性，为临床合理选用抗菌药物提供依据。方法对2005-2008年手足创伤感染标本分离出的病原菌，采用纸片扩散法（K—B法）进行药敏试验，对病原菌耐药率进行分析。结果分离出242株病原菌，革兰阴性杆菌163株，占67．4％，主要为铜绿假单胞菌、大肠埃希菌、阴沟肠杆菌、肺炎克雷伯菌和鲍氏不动杆菌；革兰阳性球菌79株，占32．6％，主要为金黄色葡萄球菌和肠球菌属；大肠埃希菌和肺炎克雷伯菌的超广谱β-内酰胺酶（ESBLs）检出率分别为53．8％和40．9％，耐甲氧西林金黄色葡萄球菌（MRSA）检出率为24．1％。结论手足创伤患者感染的病原菌以革兰阴性杆菌为主，检出率最高的是金黄色葡萄球菌，主要致病菌常为多药耐药，应加强病原菌的监测，指导临床合理用药，减少耐药菌株的产生。

OBJECTIVE To analyze the drug resistance of pathogens in patients with hand and foot trauma, in avder to provide a basis for clinical rational use of antimicrobial agents. METHODS From 2005 to 2008, pathogens were isolated from specimens of trauma of hand-foot-infecion, using disk diffusion method （K-B method） to carry out drug sensitivity test, the rate of pathogen resistance analysis. RESULTS Among 242 pathogens isolated, Gram- negative bacilli accounting for 67.4%, mainly Pseudornonas aeruginosa, Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae and Acinetobacter baumannii, Gram-positive cocci accounting for 32.6 %, mainly Staphy- lococcus aureus and Enterococcus. E. coli and K. pneumoniae of extended-spectrum β-lactamase （ESBLs） detection rate of 53. 8% and 40. 9%, respectively. Meticillin-resistant S. aureus （MRSA） detection rate was 24.1%. CONCLUSIONS Hand, Foot and pathogen infection in trauma patients with Gram-negative bacilli mainly detected the highest rates of S. aureus are the main pathogens often multi-drug resistance. We should strengthen the monitoring of pathogens to guide clinical rational drug use and reduce drug resistance the emergence of strains.