骨科无菌手术切口感染的病原菌分布及耐药性分析

Pathogenic bacteria distribution in orthopedic aseptic incision infections and its resistance analysis

目的对骨科无菌手术患者的感染主要部位、病原菌分布情况以及耐药性进行分析,总结骨科患者感染的特点,进而得出合理用药依据。方法对2014年6月-2016年6月来本院接受无菌手术治疗的2 112例骨科住院患者的临床资料进行分析。结果 2 112例骨科无菌手术患者出现医院感染为100例,患者感染率为4.73%。其中患者的医院感染例次110例次。常见的感染部位依次为手术切口(占44.5%)、泌尿道(占27.3%)以及下呼吸道(占10.0%)。就病原菌株数来看,革兰阴性菌分布最多(占53.3%),其次为革兰阳性菌(占41.9%),真菌最少(占4.8%)。根据药敏试验来看,主要病原菌对常用抗菌药具有较高的耐药率,其中革兰阳性菌对万古霉素的耐药率最低,革兰阴性菌对亚胺培南的耐药率最低。结论接受无菌手术的骨科患者发生切口感染的概率较高,且病原菌感染情况较复杂,医护人员需合理使用抗菌药物,从源头上预防患者感染的发生,降低患者的感染率。

Objective To analyze the main infected sites, pathogenic bacteria distribution and drug resistance of patients with orthopedic aseptic surgery, and to summarize the infection characteristics, so as to provide basis for rational use of drugs. Methods The clinical data of 2 112 orthopedic inpaticnts who accepted aseptical surgery from June 2014 to June 2016 were analyzed. Results There were 100 cases of nosocomial infection in 2 112 patients with orthopedic aseptic surgery, and the infec- tion rate was 4. 73% , with the nosocomial infection of llO case/time. The common infection sites were surgical incision （44.5%） , urinary tract（27.3% ） and lower respiratory tract（ 10.0% ） successively. The gram - negative bacteria（53.3% ） has the widest distribution of pathogenic bacteria strains, followed by the gram -positive bacteria（41.9% ） and Fungi（4.8% ）. According to the drug sensitivity test, the main pathogenic bacteria has a high drug resistance rate to the commonly used antibi- otics, in which the gram positive bacteria has the lowest drug resistance rate to vancomycin and the gram - negative bacteria has the lowest drug resistance rate to imipenem. Conclusion The probability of incisional infection in orthopedic patients with a- septic surgery is high, and the infection of pathogens is complicated. The medical staff should use antibiotics reasonably to pre- vent the infection from the source and reduce the infection rate of the patients.