228例开放性骨折感染患者病原菌分布及药敏分析

Distribution and drug susceptibility analysis of bacterial pathogens causing infections in 228 patients with open fracture

目的研究开放性骨折感染的主要病原菌及其药物敏感性情况,为临床开放性骨折预防感染治疗提供依据。方法回顾性分析228例开放性骨折感染住院患者的伤口分泌物细菌培养和药敏分析。结果革兰阴性菌检出率为53.62%,高于革兰阳性菌的46.38%;常见细菌检出率由高到低依次为粪肠球菌、铜绿假单胞菌、金黄色葡萄球菌、鲍氏不动杆菌、表皮葡萄球菌,其检出率分别为14.89%、13.62%、13.19%、12.77%、11.06%。结论伤口分泌物中革兰阳性菌耐药性增高,对各种抗菌药物敏感性并不集中;革兰阴性菌中对亚胺培南的敏感性降低;开放性骨折术中应严格无菌操作,充分清创;术后使用合理的抗菌药物预防感染。

OBJECTIVE To study the distribution and drug desistance of bacteria from infection of open fracture,to prevent the infection of open fracture in the Clinic.METHODS The distribution and drug resistance of bacteria from 228 infection cases with open fracture were retrospectively analyzed.RESULTS The detection rate of Gram-negative bacteria（53.62%） was higher than Gram-positive bacteria（46.38%）.The detection rates of common bacteria from high to low were： Enterococcus faecalis（14.89%）,Pseudomonsa aeruginosa（13.62%）,Staphylococcus aureus（13.19%）,Acinetobacter baumannii（12.77%）,S.epidermidis（11.06%）.CONCLUSION The rate of drug desistance of gram positive bacteria is higher.Gram-negative bacteria has low sensibility to imipenem.The sufficient wound debridement and strict aseptic processdure in open fracture patient are important.And rational use of antibiotics after operation should be also noticed.