关节腔穿刺液的病原菌种类分布及耐药性分析

Species distribution and drug resistance of pathogenic bacteria in joint cavity

目的了解关节病患者关节腔穿刺液的病原菌种类分布及耐药性情况。方法收集2015年-2017年本院关节病患者的关节腔穿刺液标本361例进行回顾性分析。结果 361例关节腔穿刺液阳性标本80例,占22. 1%,占比由高到低排列依次为革兰阳性菌10. 2%、真菌8. 6%、革兰阴性菌3. 3%。革兰阳性菌中以金黄色葡萄球菌最多见,检出率为2015年5. 2%(5/97)、2016年4. 8%(5/105)、2017年4. 4%(7/159),甲氧西林敏感的金黄色葡萄球菌(MSSA)占76. 5%(13/17),耐甲氧西林金黄色葡萄球菌(MRSA)占23. 5%(4/17),对青霉素、红霉素耐药率高。真菌中以光滑念珠菌最多见,对三唑类药物敏感度低。结论金黄色葡萄球菌检出率并没有随着手术量增加而增加,真菌检出率逐年上升,革兰阴性菌检出最低。早期、准确地检出病原菌是有效治疗关节病患者的前提。

Objective To study the distribution and drug resistance of pathogenic bacteria in articular cavity puncture fluid in patients with arthrosis. Methods A retrospective analysis was performed on 361 cases of articular puncture specimens collected from patients with arthrosis in our hospital from 2015 to 2017. Results A total of 361 specimens of articular cavity puncture fluid were obtained in 80 cases( 22. 1%). The descending order from high to low was: Gram-positive bacteria( 10. 2%),Fungi( 8. 6%),Gram-negative( 3. 3%). Staphylococcus aureus was the most common in Gram-positive bacteria,with a detection rate of 5. 2% in 2015( 5/97),4. 8% in 2016( 5/105),4. 4% in 2017( 7/159). Methicillin-sensitive gold Staphylococcus aureus( MSSA) accounted for 76. 5%( 13/17),methicillin-resistant Staphylococcus aureus( MRSA) accounted for 23. 5%( 4/17),which were high resistant to penicillin,erythromycin. In Fungi,Candida glabrata was the most common,showing low sensitivity to triazole drugs. Conclusion The detection rate of Staphylococcus aureus did not increase with the increase of operation volume. The detection rate of Fungi increased year by year,and the detection rate of Gram-negative bacteria was the lowest. Early,accurate detection of pathogens is an effective pre-treatment of patients with joint disease.