81例创伤后感染患者的分泌物细菌分布分析及药物治疗

Bacterial Distribution in Secretions of Post-Traumatic Patients with Infections and the Drug Treatment

目的分析创伤后骨感染患者分泌物的细菌分布及药物治疗为治疗骨感染提供参考。方法收集2012年1月-10月的创伤骨科分泌物培养阳性的患者病例资料,对细菌的分布及耐药规律进行总结。结果 81例分泌物培养阳性的患者,一种菌感染的患者57例占70.37%,混合感染24例占29.62%,检出率较高的为金黄色葡萄球菌和凝固酶阴性的葡萄球菌,阴沟肠杆菌、大肠埃希菌和铜绿假单胞菌。所有患者住院期间均接受了手术治疗及静脉抗菌药物治疗,同时结合局部抗菌药物骨水泥或人工骨治疗19例,局部灌洗治疗2例。结论目前创伤后骨感染以单一细菌感染和革兰阳性菌感染为主,抗菌药物骨水泥局部治疗已成为临床治疗骨感染的有效手段。

OBJECTIVE To analyze the bacterial distribution of secretions in post-traumatic cases with bone infections and sum- marize the drug treatments in practice, thus to provide reference for treatment of bone infections. METHODS The clinical data of traumatic patients with positive secretion cultures were collected from January to October in 2012. RESULTS Eighty-one cases of positive secretion cultures were selected, of whom 57 （ 70. 37% ） patients had single bacteria infection, 24 （ 29. 62% ） cases had mixed infections. Staphylococcus aureus, coagulase-negative staphylococci, enterobacter cloacae, escherichia coli and pseudomonas aeruginosa were common pathogens. All the patients underwent surgical treatment and intravenous antibiotic therapy during hospitaliza- tion. Nineteen cases were implanted with antibiotic bone cement and 2 cases received local lavation. CONCLUSION Post-traumatic bone infections are mostly caused by single bacteria and Gram-positive bacteria. Topical antibiotic bone cement treatment has become an effective treatment for bone infections.