微创治疗腰椎间盘突出症患者感染的调查分析

Investigation and analysis of infections in lumbar disc herniation receiving minimally invasive treatment

目的研究微创治疗腰椎间盘突出症的患者感染部位、病原菌的分布及耐药性,指导临床控制和预防微创治疗腰椎间盘突出症的患者发生感染。方法选取2011年3月-2013年3月进行微创治疗腰椎间盘突出症的患者878例,用BACTECTM9000全自动培养系统进行细菌培养和鉴定,并利用K-B琼脂法进行药敏试验。结果 878例腰椎间盘突出症患者发生感染76例,感染率为8.66%;其中微创部位、呼吸系统、泌尿系统、生殖系统感染分别占38.16%、23.68%、15.79%、10.53%;共培养出病原菌83株,其中革兰阳性菌32株占38.56%,革兰阴性菌51株占61.44%;革兰阳性菌对乙酰唑胺和替考拉宁的耐药率较低,均<6.00%,革兰阴性菌对美罗培南和亚胺培南耐药率为0。结论微创治疗腰椎间盘突出症患者感染率较高,临床医护人员应采取措施控制医院感染的发生,选择耐药率低的抗菌药物进行及时的治疗。

OBJECTIVE To study the status of infection caused by minimally invasive in the treatment of lumbar disc herniation and the pathogens bacteria and their drug resistance so as to control and prevent the infection . METHODS A total of 878 cases of lumbar disc herniation patients for minimally invasive treatment from Mar 2011 to Mar 2013 were chosen .The pathogens were isolated and cultured by the BACTECTM9000 automatic culture system ,and their drug resistance was studied by K-B agar assay .RESULTS The incidence of infections caused by minimally invasive in the treatment of lumbar disc herniation was 8 .66% （76 cases） among the 878 cases of patients .The infection rates of invasive parts ,respiratory system ,urinary system ,and reproductive system were 38 .16% ,23 .68% ,15 .79% ,and 38 .16% respectively . Totally 83 strains of pathogenic bacteria have been cultured ,including 32 （38 .56% ）strains of gram-positive bacteria and 51 （61 .44% ） strains of gram-negative bacteria .The drug resistance rates of the gram-positive bacteria to teicoplanin and acetazolamide were less than 6 .00% ;the drug resistance rates of the gram-negative bacteria to meropenem and imipenem were 0 . CONCLUSIONS The occurrence rate of infections caused by minimally invasive in the treatment of lumbar disc herniation is high .Medical staff should take measures to control the infections .The antibiotics that have low drug resistance rates should be chosen for timely treatment .