整形外科手术感染患者病原菌分布及耐药性分析

Distribution and drug resistance of pathogens causing infections in the patients undergoing orthopedic surgery

目的研究整形外科手术感染患者的细菌分布及病原菌的耐药性,指导临床合理使用抗菌药物。方法对2006-2011年外科手术整形感染患者进行分析,检测病原菌的来源、种类构成以及主要病原菌的耐药性。结果共检出病原菌626株,主要来自血液标本,占20.82%,其次为患者分泌物占16.92%,感染部位的脓液占13.66%,尿液占12.36%,引流液占10.20%;金黄色葡萄球菌、大肠埃希菌、铜绿假单胞菌、粪肠杆菌、凝固酶阴性葡萄球菌及阴沟肠杆菌为主要的病原菌;主要革兰阳性菌对克拉霉素和利奈唑胺的耐药率极低,<1.00%;主要革兰阴性菌对亚胺培南和美罗培南的耐药率较低,<18.00%。结论应根据药敏结果合理选择使用抗菌药物,避免引起细菌的耐药性。

OBJECTIVE To study the distribution and drug resistance of the pathogens causing infections in the patients undergoing orthopedic surgery so as to guide the reasonable use of antibiotics. METHODS The patients who underwent the orthopedic surgery from 2006 to 2011 and were infected were analyzed, the composition of clinical specimens, the type of infection, and the drug resistance of the main pathogens were detected. RESULTS Of totally 626 strains of pathogens isolated, 20. 82%o were isolated from the blood specimens, followed by the secretions（16.92%）, the pus （13.66%）, the urine （12.36%） ,and the drainage fluid （10.20%） . Staphylococcus aureus , Escherichia coli , Pseudomonas aeruginosa , Enterobacter f aecalis , coagulase-negative Staphylococci and Enterobacter cloacae were the predominant species of pathogens; the drug resistance rates of the gram-positive bacteria to clarithromycin and linezolid were extremely low,with less than 1.00%; the drug resistance rates of the gram-negative bacteria to imipenem and meropenem were extremely low, with less than 18.00 %. CONCLUSION It is necessary to reasonably use antibiotics based on the drug susceptibility testing result so as to prevent the drug resistance of pathogens.