手足外科患者感染的病原菌分布和耐药性分析

Analysis of pathogen ic bacteria distribution and drug resistance in hand and foot surgical patients

目的探讨手足外科患者伤口感染的病原菌分布特点及耐药性,为合理应用抗生素提供依据。方法回顾性分析2014年6月-2016年12月收治的3418例手足外伤患者200例伤口感染发生情况,并分析感染患者的细菌学分布特点和耐药性。结果感染200例,感染率为5.9%。共检测出致病菌213株,其中革兰氏阴性菌142株,占66.7%,革兰氏阳性菌71株,占33.3%。病原菌感染率由高到低分别为大肠埃希氏菌、阴沟肠杆菌、铜绿假单胞菌、溶血性葡萄球菌和表皮葡萄球菌,分别占21.1%、12.7%、11.3%、8.5%、5.6%。感染以革兰氏阴性菌为主,其中3例铜绿假单胞菌对亚胺培南耐药,对青霉素类抗菌药物耐药率最高。结论手足外伤伤口感染的因素很多,病原菌种类繁多。通过加强病原菌及耐药性检测,可以有效指导合理应用抗菌药物,从而降低患者感染率。

Objective To explore the distribution and drug resistance of pathogenic bacteria in hand and foot surgical patients,and to provide basis for the rational use of antibiotics.Methods The incidence of wound infection in 3418 patients with hand and foot trauma was retrospectively analyzed,meanwhile,the bacteriological distribution characteristics and drug resistance of infected patients were analyzed.Results Two hundred cases were infected,the infection rate was 5.9%.A total of 213 pathogenic bacteria were detected,including 142 Gram-negative bacteria(66.7%),71 Gram-positive bacteria(33.3%).The infection rates of pathogenic bacteria from high to low were Escherichia coli,Enterobacter cloacae,Pseudomonas aeruginosa,Staphylococcus haemolyticus and Staphylococcus epidermidis,accounting for21.1%,12.7%,11.3%,8.5%and 5.6%respectively.Among them,3 cases of Pseudomonas aeruginosa were resistant to imipenem,and the resistance rate to penicillin was the highest.Conclusion There are many factors of hand and foot injury wound infection,and many kinds of pathogenic bacteria.By strengthening the detection of pathogenic bacteria and drug resistance,it can effectively guide the rational use of antimicrobial agents,thus reducing the infection rate of patients.