四川汶川地震中转送创伤患者感染特点及病原菌分析

Analysis of Infection Characteristic and Pathogens in Transferred Traumatic Patients in Eathquake of Wenchuan,Sichuan Province

目的 探讨汶川地震中转送的创伤患者感染及病原学特点,为临床抗感染治疗提供依据.方法 对某院收治的四川汶川地震后从灾区转送伤员的相关感染情况进行调查分析.结果 转送入院的76名地震伤员中,有15名患者存在感染,感染率为19.74%.其中有创面的14例患者中有10例患者存在创面感染,创面感染率达71.43%.创面感染患者感染病原菌以阴沟肠杆菌、不动杆菌为主;阴沟肠杆菌对二、三代头孢菌素、喹诺酮类等药物均耐药,仅对亚胺培南和美罗培南敏感,鲍曼不动杆菌对多种头孢菌素类抗菌药物耐药,对加酶抑制剂的头孢哌酮/舒巴坦均敏感,但检出对亚胺培南和美罗培南耐药菌株.所有创面均未分离出破伤风芽孢杆菌和产气荚膜梭菌.结论 地震创伤患者的创面感染率高,耐药性严重.加强和重视感染患者的病原菌检测,采取积极有效的预防和干预措施对控制感染非常重要.

Objective To investigate the infection characteristic in transferred traumatic patients in eathquake in order to provide reasonable evidence for anti-infective therapy. Methods A study on infection characteristic in traumatic patients in eathquake was conducted. Results In 76 patients,there were 15 patients infected when they were in hospital. The infection rate was 19.74 %. Among them, 10 patients got traumatic infection. The infection rate was 71.43 %. The main pathogens of traumatic infection patients were Enterobacter cloacae and Acinetobacter. Enterobacter cloacae was resistance to Cephalosporin and quindone. This kind of bacterium was just sensitive to Imipenem and Meropenem. Acinetobacter was resistance to Cephalosporin but sensitive to Sulbactam which was added enzyme inhibitors. Acinetobacte which was resistance to both Imipenem and Meropenem had been detected. No Tetanus bacillus,Clostridium perfringens were isolated. Conclusions The infection rate of traumatic infection patients was high. Most of the wound surface were infected with some bacterial with multidrug resistant. It is very important to find pathogens immediately and take precaution and control measures of nosoeomial infection.