脊柱手术术后切口感染病原茵培养及耐药性分析

Culture of Pathogenic Bacteria and Drug Resistance Analysis in Postoperative Infection of Spinal Op＇eration

【目的】分析脊柱手术术后切口感染（postoperativeinfectionofspinaloperation，PISO）的病原茵分布特点及耐药情况，为临床合理用药提供指导。【方法】回顾性分析2002年6月至2012年6月期间脊柱术后切口感染患者的病原茵分布状况及抗菌药物敏感试验结果。【结果】培养出病原茵42株，其中革兰阴性菌（G-）25株，占59．52％，革兰阳性茵（G＋）17株，占40．48％；G-菌中以大肠埃希菌（10／42）、铜绿假单胞茵（7／42）、肺炎克雷伯菌（4／42）、鲍曼不动杆菌（3／42）为主，G＋茵中以金黄色葡萄球菌（9／42）、表皮葡萄球菌（6／42）为主。大肠埃希菌对头孢哌酮／舒巴坦（90．0％）及亚胺培南（100．0％）最敏感。金黄色葡萄球菌对万古霉素最敏感（100．0％）。【结论】G＋菌及G-菌均能在脊柱外科术后切口感染中出现，并以G-菌感染为主，治疗应根据细菌培养及药物敏感试验结果，合理使用抗茵药物。

[Objective] To analyze the features of pathogenic bacteria distribution and ＆ug resistance in postoperative infection of spinal operation（PISO） so as to provide the reference for rational administration in clinical practice. [Methods] Distribution of pathogenic bacteria and drug sensitivity test results of antibacterials in spine department of our hospital from June 2002 to June 2012 were analyzed retrospectively. [Results] The 42 strains of pathogens were isolated. Among these 42 strains of pathogens, 25 strains（59.52 %） were gram-negative bacterium and 17 strains（40.48 % ） were gram-positive bac- terium. The major gram-negative bacterium were Escherichia coli （ 10/42）, Pseudomonas aeruginosa （7/42）, Klebsiella pneumoniae（4/42） and Acinetobacter baumannii（3/42）. The major gram-positive bacterium were Staphylococcus aureus（9/ 42） and S. epidermidis（6/42）. The most sensitive antibiotics for Escherichia coli were cefoperazone/Sulbactam（90.0%） and imipenem（100.0 %）. The most sensitive antibiotic for S. aureus was vancomycin（100.0%）. [Conclusion]Gram-posi- tive bacterium and gram-negative bacterium are observed in patients with P｜SO, and the main bacteria is G- bacillus. The rational use of antimicrobial drugs should be based on the results of bacterial culture and drug-sensitive test.