2014年骨科伤口感染患者病原菌分布及耐药性分析

Bacterial distribution and resistance in orthopedic patients with wound infections in 2014

目的了解本院2014年度骨科伤口感染病原菌分布情况并对其耐药性进行分析。方法应用VITEK-2Compacts全自动细菌鉴定仪进行细菌鉴定及药敏试验。结果骨科伤口感染标本中共分离到864株致病菌,其中革兰阳性菌451株(52.2%),革兰阴性菌398株(46.1%)。革兰阳性菌中主要为金黄色葡萄球菌233株(27.0%);革兰阴性菌中主要为铜绿假单胞菌94株(10.9%),阴沟肠杆菌63株(7.3%)、鲍曼不动杆菌58株(6.7%)。金黄色葡萄球菌对万古霉素、替加环素、呋喃妥因、喹努普汀/达福普汀和利奈唑胺均敏感率均为100.0%。革兰阴性菌中鲍曼不动杆菌耐药情况较为严重,对多种抗菌药物耐药率大于50%。结论该院骨科感染主要病原菌为金黄色葡萄球菌为主,铜绿假单胞菌、阴沟肠杆菌为革兰阴性菌中的主要致病菌,细菌耐药形势仍很严峻,应采取更加积极有效的措施控制耐药菌的增多与传播。

Objective To investigate the bacterial distribution and resistance in orthopedic patients with wound infections in the hospital in 2014 .Methods The bacteria identification and the antimicrobial susceptibility test were conducted by VITEK‐2 compact automatic system .Results A total of 864 pathogenic strains were collected ,with Gram‐positive bacteria 451 strains （52 .2% ） , Gram‐negative bacteria 398 strains（46 .1% ） .The first major pathogens of Gram‐positive bacteria were Staphylococcus aureus（n=233 ,27% ）;The top three pathogens of Gram‐negative bacteria were Pseudomonas aeruginosa（n=94 ,10 .9% ） ,Enterobacter cloacae （n=63 ,7 .3% ） ,Acinetobacter baumannii（n=58 ,6 .7% ） .All the Staphylococcus aureus isolates were susceptible to vancomycin , tigecycline ,nitrofuratoin ,quinupristin/dalfopristin ,linezolid .The resistant rates of Acinetobacter baumannii were higher than 50%to multiple antibiotics .Conclusion Staphylococcus aureus were predominant pathogens in orthopedic patients with wound infec‐tions in our hospital .Meantime ,Pseudomonas aeruginosa and Enterobacter cloacae were the prime pathogens in the Gram‐negative bacteria .The drug‐resistance situation is still severe ,and more effective measures should be taken to control the dissemination and growth of resistant strains .