603株骨科患者伤口感染病原菌分布及耐药性监测

Pathogenic bacteria distributions and drug resistance surveillances of 603 bacterial strains for wound infection of orthopedic patients

目的了解该院骨科患者伤口感染的病原菌分布及耐药性趋势,为临床合理使用抗菌药物提供依据。方法采用VITEK 2Compact自动细菌鉴定仪进行细菌鉴定及药敏试验,分析骨科患者伤口分泌物病原菌分布及耐药情况。结果从3 317份标本中共分离出细菌603株,其中革兰阳性球菌占56.4%,革兰阴性杆菌占40.8%,假丝酵母菌占2.8%。前7种菌种依次为表皮葡萄球菌(15.4%)、铜绿假单胞菌(11.0%)、金黄色葡萄球菌(7.6%)、溶血葡萄球菌(7.3%)、粪肠球菌(6.8%)、阴沟肠杆菌(6.3%)和大肠埃希菌(3.5%)。耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌分别为24.0%和38.7%,大肠埃希菌产超广谱β-内酰胺酶发生率60.0%。结论骨科伤口感染病原菌以革兰阳性球菌为主,内源性正常菌群和来自周围环境中的条件致病菌已成为骨科伤口感染的主要致病菌,万古霉素及亚胺培南仍保持较高的抗菌活性。

Objective To comprehend the pathogenic bacteria distributions and drug resistance tendencies and to provide the basis of rational use for the antimicrobial drugs in the clinical.Methods VITEK 2Compact Automatic bacteria identification equipment was used to identify the bacteria and to accomplish the drug sensitive test.The pathogenic bacteria distributions and drug resistance circumstances were analyzed for the wound secretion in the orthopedic patients.Results 603 strains bacteria were separated from 3 317 specimens and the gram positive bacteria accounted for 56.4%,the gram negative bacteria accounted for 40.8%,the candida is 2.8%.In front of the seven kinds of strains are the epidermis staphylococcus（15.4%）,the pseudomonas aeruginosa（11.0%）,the staphylococcus aureus（7.6%）,the hemolysis staphylococcus（7.3%）,the Enterococcus faecalis（6.8%）,the sewer enterobacter（6.3%）and the E.coli pin（3.5%）in the order.The methicillin-resistants aureus bacteria and the coagulase negative staphylococcus aureus is 24.0% and 38.7% respectively.The incidence rate of E coli pin to produce super broad spectrumβ-lactamase（ESBLs）is 60.0%.Conclusion The gram positive bacteria are main bacteria in the pathogenic bacteria of the orthopedic wound infection.The endogenous normal flora or the conditioned pathogen from the surrounding environment has become the main pathogenic bacteria of the orthopedic wound infection.The vancomycin and imipenem still keep higher antimicrobial activity.