胸腰椎体后路内固定术后切口感染的病原学与药敏分析

Microbiology research and drug sensitive situation of infections after posterior internal fixation in thoracolumbar spines

目的对医院胸腰椎体后路内固定患者术后深部切口感染的病原学和药敏状况进行分析,为临床治疗提供参考依据。方法选择2010年5月-2015年4月医院胸腰部位椎体后路内固定术后切口感染的96例患者进行回顾性研究,选取术中可疑标本做病原培养,分析病原菌种类及药敏结果,数据采用SPSS 17.0软件进行统计分析。结果 96例切口感染患者送检标本共分离出病原菌96株,以革兰阳性菌为主,共73株占76.04%;革兰阳性菌中主要为耐甲氧西林葡萄糖球菌,占33.33%;耐甲氧西林凝固酶阴性葡萄球菌对替考拉宁、左氧氟沙星敏感率为100.00%。结论胸腰部位椎体后路内固定术后深部外科切口感染的患者中,革兰阳性菌检出率最高,预防性用药应选择万古霉素、左氧氟沙星或亚胺培南;并根据药敏试验的结果合理选择抗菌药物。

OBJECTIVE To analyze the etiology and drug sensitivity condition of deep incision infections in patients after posterior internal fixation of thoracolumbar spine so as to provide references for clinical treatments. METHODS Totally 96 cases with incision infections after posterior internal fixation of thoracolumbar spine from May 2012 to Apr. 2015 were researched retrospectively. The suspicious samples were chosen for pathogen cul- tures. The pathogen types and drug sensitivity results were statistically analyzed by SPSS 17.0. RESULTS In 96 cases of the objects, 96 strains of pathogens were isolated from the samples, dominating by gram-positive bacteri- a, with 73 strains accounting for 76.04%. In those gram-positive bacteria, 33% were methicillin-resistant Staph- ylococcus, and all the methicillin-resistant coagulase negative Staphylococcus were totally sensitive to teicoplanin and levofloxacin. CONCLUSION Gram-positive bacteria are the main cause for incision infections in patients after posterior internal fixation of thoracolumbar spine. Vancomycin, levofloxacin or impenem can be chosen as preven- tive drugs and antibiotics should be rational applied according to drug sensitivity test.