慢性骨髓炎患者感染病原菌分布及药物敏感性研究

Distribution and drug susceptibility of pathogens causing infections in patients with chronic osteomyelitis

目的探讨慢性骨髓炎患者感染的致病菌和药物敏感性,为临床用药提供指导。方法选取2010年3月-2015年10月医院收治的慢性骨髓炎感染患者80例,进行细菌培养、鉴定及药敏试验,分析革兰阳性菌及革兰阴性菌分布情况及对抗菌药物的敏感性。结果共检出病原菌106株,革兰阳性菌51株,占48.11%,其中金黄色葡萄球菌占总体的29.25%,革兰阴性菌55株,其中铜绿假单胞菌、阴沟肠杆菌、大肠埃希菌最为常见,分别占总体的16.98%、10.38%、7.55%;金黄色葡萄球菌、表皮葡萄球菌、粪肠球菌对利奈唑烷、万古霉素的敏感率高达100.00%,铜绿假单胞菌、阴沟肠杆菌、大肠埃希菌对美罗培南的敏感率均为100.00%。结论慢性骨髓炎患者以革兰阴性菌感染为主,且金黄色葡萄球菌感染比例较大,临床上应根据感染菌株选择敏感率高的抗菌药物。

OBJECTIVE To explore the distribution and drug susceptibility of pathogenic bacteria causing infections in patients with chronic osteomyelitis so as to provide guidance for clinical use of antibiotics .METHODS A total of 80 patients with chronic osteomyelitis who were treated in the hospital from Mar 2010 to Oct 2015 were enrolled in the study .The bacterial culture ,identification ,and drug susceptibility testing were carried out;the distribution and drug susceptibility of gram‐positive bacteria and gram‐negative bacteria were observed .RESULTS Totally 106 strains of pathogens were isolated ,including 51 （48 .11% ） strains of gram‐positive bacteria and 55 strains of gram‐negative bacteria;the Staphylococcus aureus accounted for 29 .25% among the gram‐positive bacteria;the Pseudomonas aeruginosa ,Enterobacter cloacae ,and Escherichia coli were the most common species of gram‐neg‐ative bacteria ,accounting for 16 .98% ,10 .38% ,and 7 .55% ,respectively .The drug susceptibility rates of the S .aureus ,Staphylococcus epidermidis ,and Enterococcus f aecalis to linezolid and vancomycin reached up to 100 . 00% ;the drug susceptibility rates of the P .aeruginosa , E .cloacae ,and E .coli to meropenem were 100 .00% . CONCLUSION The gram‐negative bacteria are dominant among the pathogens causing the infections in the patients with chronic osteomyelitis ,and the patients with S .aureus infection occupies a large proportion .It is necessary for the hospital to reasonably use antibiotics based on the result of the drug susceptibility testing .