闭合性骨折术后切口感染20例病原学特征分析

Analysis of pathogenic characteristics of incision infection after closed fracture

目的探讨闭合性骨折术后切口感染病原学特征。方法选择兰溪瑞康医院2012年1月至2017年12月收治的闭合性骨折术后切口感染患者20例为研究对象,采集闭合性骨折术后切口感染分泌物标本,进行病原菌分离鉴定及药敏试验。结果闭合性骨折术后切口感染患者20例分离培养病原菌33株,其中革兰阴性菌21株、革兰阳性菌11株、真菌1株。革兰阴性菌中,铜绿假单胞菌8株、大肠埃希菌6株;革兰阳性菌中,金黄色葡萄球菌6株。铜绿假单胞菌对头孢曲松、头孢他啶和头孢哌酮耐药率较高,分别为87.50%、87.50%和75.00%;大肠埃希菌对头孢曲松和头孢他啶耐药率较高,分别为100.00%和83.33%。金黄色葡萄球菌对青霉素G和红霉素耐药率较高,分别为100.00%和83.33%。结论闭合性骨折术后切口感染病原菌前三位病原菌分别为金黄色葡萄球菌、铜绿假单胞菌和大肠埃希菌,以革兰阴性菌为主,主要革兰阴性菌对头孢类药物耐药率高,主要革兰阳性菌对青霉素G和红霉素耐药率高。

Objective To investigate the etiological characteristics of incision infection after closed fracture surgery. Methods From January 2012 to December 2017, 20 closed fracture patients with postoperative incision infection in Lanxi Ruikang Hospital were selected in the research.The wound infection and secretion samples after closed fracture surgery were collected for isolation and identification of pathogenic bacteria and drug sensitivity test. Results A total of 33 strains of pathogenic bacteria were isolated and cultured in 20 cases of wound infection after closed fracture operation, including 21 Gram-negative bacteria, 11 Gram-positive bacteria and 1 fungi.Among Gram-negative bacteria, 8 strains of Pseudomonas aeruginosa and 6 strains of Escherichia coli were found.Among Gram-positive bacteria, 6 strains of Staphylococcus aureus were found.The resistance rates of Pseudomonas aeruginosa to ceftriaxone, ceftazidime and cefoperazone were 87.50%, 87.50% and 75.00%, respectively, and the resistance rates of Escherichia coli to ceftriaxone and ceftazidime were 100.00% and 83.33%, respectively.The resistance rates of Staphylococcus aureus to penicillin G and erythromycin were 100.00% and 83.33%, respectively. Conclusion The pathogenic bacteria of closed fracture postoperative incision infection are Gram-negative bacteria, three pathogenic bacteria were Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli, the drug resistance rate of Gram negative bacteria to cephalosporin is high, the resistance rate of main Gram positive bacteria to penicillin and erythromycin G is high.