枣阳地区外伤患者术后院内多重耐药菌株混合感染的检验分析

Analysis on detection results of postoperative mixed infection of multi-drug resistant bacterial strains among traumatic patients in Zaoyang area

目的分析枣阳地区外伤患者术后院内多重耐药菌株混合感染的病原菌分布及抗菌药物耐药情况,为临床治疗提供参考。方法选取合并多重耐药菌株混合院内感染的外伤患者71例,根据感染部位不同取标本进行细菌培养和耐药性分析,并对结果进行统计。结果 71例多重耐药菌株混合感染患者共分离得到多重耐药菌株205株。其中革兰阴性菌检出119株(58.05%),革兰阳性菌检出83株(40.49%),真菌检出3株(1.46%)。大肠埃希菌、肺炎克雷伯菌、肠杆菌、沙雷菌均对10种以上抗菌药物的耐药性超过50%,其中对氨苄西林、头孢噻吩、头孢呋辛、阿洛西林、头孢噻肟、头孢哌酮的耐药率均超过80%。而对亚胺培南以及阿米卡星的耐药性则分别仅有5.88%和28.57%。以金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌、肺炎链球菌为代表的革兰阳性菌对青霉素G、苯唑西林、氨苄西林的耐药率分别为98.80%、97.59%、95.18%。没有革兰阳性菌对万古霉素耐药,此外对利福平、氯霉素的耐药率也分别仅为32.53%和34.94%。结论在感染早期,尚不能明确致病微生物的种类时也难以选择敏感的抗菌药物,在这种情况下联合应用亚胺培南及万古霉素是不错的选择。

Objective To investigate the pathogenic bacterial distribution and drug resistance situation of multi-drug resistant bacterial strain mixed infection among postoperative traumatic patients in Zaoyang area to provide a reference for clinical treatment.Methods A total of 71 traumatic cases of multi-drug resistant bacterial strain mixed nosocomial infection were selected and performed the bacterial culture and drug resistance analysis according to the samples taking from different infection sites.The the results were statistically analyzed.Results Among 71 cases of multi-drug resistant strains mixed infection,205multi-drug resistant strains of bacteria were isolated.Among them,119（58.05%）strains were Gram-negative bacteria,Gram-positive bacteria was in 83strians（40.49%）and fungus was in 3strains（1.46%）.The resistance of Escherichia coli,Klebsiella pneumoniae,Enterobacter and Serratia to more than 10 kinds of antibacterial drugs was more than 50%,which to ampicillin,cephalothin,cefuroxime,azlocillin,cefotaxime cefuroxime,azlocillin,cefotaxime and cefoperazone was more than 80%,while which to imipenem and amikacin was only5.88% and 28.57%respectively.The resistance rates of Gram-positive bacteria represented by Staphylococcus aureus,Staphylococcus epidermidis,Staphylococcus haemolyticus and Streptococcus pneumoniae to penicillin G,oxacillin and ampicillin generally reached 98.80%,97.59%,and 95.18% respectively.No Gram-positive bacteria was resistant to vancomycin,in addition the resistance to rifampin and chloramphenicol also was only 32.53% and 34.94% respectively.Conclusion In early stage of infection,it is unable to determine the types of pathogenic bacteria and difficult to select sensitive antibacterial drugs,under this occasion,the combination of imipenem and vancomycin is a good choice.