骨科创面感染病原菌分布与耐药性分析

Analysis of pathogen distribution and drug resistance of wound infection in department of orthopedics

目的分析骨科创面感染病原菌的分布及药敏性,为临床治疗骨科感染创面合理用药及减少耐药菌产生提供科学依据。方法对骨科创面感染患者创面标本检出的病原菌监测资料作回顾性分析,并采用纸片扩散法检测药物敏感性。结果 479株骨科创面感染病原菌中,感染部位以四肢为主,检出446株;从感染原因看,以创伤及切口感染为主,分别检出348株、86株;病原学分布提示,以细菌为主,检出473株,其中革兰阳性菌检出228株;革兰阴性菌检出245株;真菌检出6株。主要革兰阳性菌对替考拉宁、万古霉素、阿莫西林/克拉维酸、阿米卡星、利福平和米诺环素敏感度较高,主要革兰阴性菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南和美罗培南耐药率较低。结论严格切口感染管理及消毒隔离制度,加强骨科创面感染病原菌及耐药性监测,合理选用敏感抗菌药物,降低创面的感染率及耐药性。

Objective To analyze the distribution and drug resistance of pathogenic wound infection in the department of orthopedics,in order to provide a scientific basis for the rational drug use and the decreasing of drug resistant bacteria in the clinical treatment of infection wound in department of orthopedics. Methods Retrospective analysis was made on the pathogenic monitoring data of a wound specimens from patients with wound infection in department of orthopedics,and the disk diffusion test was performed for the drug susceptibility. Results Out of the 479 strains of pathogenic bacteria of wound infection in the department of orthopedics,mainly the infection of the limbs,446 were detected; from the cause of infection,infection wound and incision were the major,348 strains and 86 strains were detected,respectively; the etiology distribution indicated that,bacteria were the main,a totalof 473 strains were detected,Gram positive bacteria were 228 strains,245 strains were detected as Gram negative bacteria,and 6 strains were detected as fungi. The main Gram positive bacteria to vancomycin,teicoplanin,amoxicillin / clavulanic acid,minocycline,rifampin and amikacin was more sensitive,and the resistance rate of the mainly Gram negative bacteria to cefoperazone / shubatan,piperacillin / tazobactam,imipenem and meropenem was low. Conclusion The incision infection management,strict disinfection and isolation system should be performed,and we should also strengthen the monitoring of wound infection pathogenic bacteria and drug resistance in the department of orthopedics,and conduct rational use of antibacterial drugs,reduce the infection rate and drug resistance of wound.