骨科创伤患者伤口感染病原菌647株分布及耐药性监测情况

Distribution and Drug Resistance Monitoring of 647 Strains of Pathogenic Bacteria from Wound Infection in Orthopedic Trauma Patients

目的:探究在骨科创伤患者诊疗过程中,患者伤口常见病原菌的分布状况及耐药性监测情况。方法:收录从2020年1-12月在本院接受诊疗的骨科创伤伤口感染患者伤口分泌物标本共890份,按照临床检验规程完成细菌的接种及培养工作,对病原菌的分布状况及不同病原菌的耐药性进行对比。结果:本次研究中所收录的890份标本共分离病原菌647株,其中革兰阴性菌的比例为51.93%(336株),革兰阳性菌占比为46.99%(304株),真菌占比为1.08%(7株)。骨科创伤伤口感染患者病原菌以革兰阴性菌居多,革兰阴性菌的主要菌株类型为阴沟肠杆菌、鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌及肺炎克雷伯菌,革兰阳性菌略低于革兰阴性菌,但金黄色葡萄球菌含量最高,占总细菌株数的36.32%(235株),多数病原菌属于多重耐药病原菌。结论:骨科诊疗过程中,骨科创伤患者伤口感染病原菌的主要类型为革兰阴性菌,其中金黄色葡萄球菌、大肠埃希菌、铜绿假单胞菌、阴沟肠杆菌及鲍曼不动杆菌为病原菌的主要类型,病原菌的耐药性为多重耐药。因此在患者接受诊疗的过程中,临床医师需要加强病菌的检测力度,为骨科患者抗感染诊疗选择诊疗效果更加出众的药物,提升骨科感染预防诊疗的诊疗效率。

Objective:To explore the distribution of common pathogens in patients’wounds and the drug resistance monitoring status during the diagnosis and treatment of orthopedic trauma patients.Method:A total of 890 specimens of wound secretions from orthopedic trauma wound infection patients who were diagnosed and treated in our hospital from January to December 2020 were collected.The inoculation and cultivation of bacteria were completed in accordance with the clinical inspection procedures,the distribution of pathogens and drug resistance of different pathogens were compared.Result:In the 890 specimens collected in this study,a total of 647 pathogenic bacteria were isolated,of which the proportion of Gram-negative bacteria was 51.93%(336 strains),and the proportion of Gram-positive bacteria was 46.99%(304 strains),the proportion of fungi was 1.08%(7 strains).Gram-negative bacteria were the most common pathogens in orthopedic trauma wound infections.The main types of Gram-negative bacteria were Enterobacter cloacae,Acinetobacter baumannii,Pseudomonas aeruginosa,Escherichia coli and Klebsiella pneumoniae.The Gram-positive bacteria were slightly lower than the Gram-negative bacteria,but Staphylococcus aureus had the highest content,accounting for 36.32%(235 strains)of the total bacterial strains.And most pathogens were found to be multi-drug resistant pathogenic bacteria.Conclusion:In the process of orthopedics diagnosis and treatment,the main types of pathogenic bacteria for wound infection in orthopedic trauma patients are Gram-negative bacteria,among which Staphylococcus aureus,Escherichia coli,Pseudomonas aeruginosa,Enterobacter cloacae and Acinetobacter baumannii are the main types of pathogenic bacteria,the drug resistance of pathogenic bacteria is multi-drug resistance.Therefore,in the process of patients receiving diagnosis and treatment,clinicians need to strengthen the detection of germs,choose drugs with more outstanding diagnosis and treatment effects for orthopedic patients’anti-infection diagnosis and treatment,and improve the diagnosis and treatment efficiency of orthopedic infection prevention diagnosis and treatment.