开放性骨折患者创面感染病原菌的分布及药物敏感性

Pathogen distribution and drug sensitivity of wound infection in patients with open fracture

目的分析开放性骨折患者创面感染病原菌的分布及药物敏感性,为此类患者的治疗提供参考。方法回顾性分析2016年8月至2019年8月我院收治的81例开放性骨折创面感染患者的临床资料,收集其创面感染病原菌培养鉴定及药物敏感试验结果,分析其病原菌分布及药物敏感性特点。结果 81例开放性骨折创面感染患者共分离病原菌113株,其中革兰阴性菌68株(60.18%),以铜绿假单胞菌(33株,29.20%)为主;革兰阳性菌30株(26.55%),以金黄色葡萄球菌(18株,15.93%)为主;真菌15株(13.27%),以白假丝酵母(10株,8.85%)为主。铜绿假单胞菌对氨曲南耐药率最高,对美洛培南不耐药。金黄色葡萄球菌对头孢西丁耐药率最高,对万古霉素耐药率最低。白假丝酵母对两性霉素耐药率最高,对伊曲康唑耐药率最低。结论开放性骨折患者创面感染病原菌以革兰阴性菌为主,病原菌对临床常用抗菌药物耐药性较高,应根据病原菌药敏特点合理选用抗菌药物。

Objective To investigate the pathogen distribution and drug sensitivity of wound infection in patients with open fracture and provide a reference for treatment. Methods The clinical data of 81 open fracture patients with wound infection from August 2016 to August 2019 were analyzed retrospectively. Then the results of bacterial culturing and drug sensitivity test of wound infection were analyzed. Results Among the 81 patients, 113 strains were cultured and isolated, including 68 strains(60.18%) of Gram-negative bacteria, 30 strains(26.55%) of Gram-positive bacteria and 15 strains(13.27%) of fungi, among which, 33 strains of Pseudomonas aeruginosa(29.20%), 18 strains of Staphylococcus aureus(15.93%) and 10 strains of Candida albicans(8.85%) were predominant in each kind. Pseudomonas aeruginosa had the highest resistance rate to Aztreonam and no resistance to Meropenem;Staphylococcus aureus had the highest resistance rate to Cefoxitin and the lowest resistance rate to Vancomycin;Candida albicans had the highest resistance rate to Amphotericin and the lowest resistance rate to Itraconazole. Conclusion The pathogens of wound infection in patients with open fracture are mainly Gram-negative bacteria, and the pathogens have a high resistance to commonly used antibiotics. Therefore, patients with open fracture should be treated with antibiotics reasonably so as to control wound infection.