创伤患者铜绿假单胞菌感染的临床特征

Clinical characteristics of Pseudomonas aeruginosa infection in trauma patients

目的了解创伤患者和非创伤患者铜绿假单胞菌耐药情况及特点,指导临床医生合理使用抗菌药物,延缓耐药,预防、控制感染。方法收集丽水市中心医院2012年1月至2018年12月分离的铜绿假单胞菌,采用VITEK-2全自动微生物鉴定仪鉴定细菌和K-B(Kirby-Bauer)法测量常用抗菌药物的敏感性。结果2012-2018年铜绿假单胞菌感染创伤患者占21.94%;以分泌物、脓液、血液、尿液等标本为主;科室以普外科、骨科、监护室为主;创伤感染患者亚胺培南、美罗培南耐药率分别为8.20%、11.48%,除了哌拉西林/他唑巴坦、阿米卡星外,非创伤患者耐药率明显高于创伤患者。结论创伤患者感染铜绿假单胞菌率较高,临床应做好彻底清创止血,严格无菌操作,严重感染患者应采用联合用药,可有效控制感染,提高治愈率及存活率。

Objective To understand the drug resistance status and characteristics of Pseudomonas aeruginosa in trauma patients and non-trauma patients,to guide clinicians to use antimicrobial drugs reasonably,delay drug resistance,prevent and control infection.Methods Pseudomonas aeruginosa isolated from Lishui Municipal Central Hospital from January 2012 to December 2018 was collected.VITEK-2 automatic microbial identification instrument was used for identifying bacteria and K-B(Kirby-Bauer)method was used for measuring the sensitivity of commonly antibiotics.Results Pseudomonas aeruginosa infected trauma patients from 2012 to 2018 accounted for 21.94%,and the main samples were secretions,pus,blood,urine,etc.Departments where infection occurs were mainly general surgery,orthopedics,and intensive care.The resistance rates to imipenem and meropenem were 8.20%and 11.48%,respectively.Except for piperacillin/tazobactam and amikacin,the drug resistance rate of non-traumatic patients was significantly higher than that of trauma patients.Conclusion The trauma patients have a higher infection rate of Pseudomonas aeruginosa.Clinically,thorough debridement,hemostasis and strict aseptic procedures should be done.Patients with severe infections should use combined medicines to effectively control infection and improve the cure rate and survival rate.