关节感染293株病原菌分布及耐药性分析

DISTRIDUTION AND DRUG RESISTANCE OF 293 STRAINS OF PATHOGENS IN JOINT INFECTION

目的对2014-2017年间关节液培养阳性标本进行病原菌的鉴定及药敏实验,以获得本院关节感染病原菌分布及耐药性情况。方法收集2014-2017年关节液培养阳性标本,采用法国梅里埃Vitek2compact进行病原菌的鉴定及药敏试验,部分菌株采用16SrRNA基因序列分析鉴定。部分抗生素使用E-test及K-B法药敏实验。使用Excel及WHONET软件对结果进行汇总分析。结果占本院关节感染首位的病原菌是金黄色葡萄球菌37.5%,其次为凝固酶阴性葡萄球菌15.35%,大肠埃希菌9.9%,铜绿假单胞菌8.87%,阴沟肠杆菌4.44%。头孢西丁耐药的金黄色葡萄球菌(methicillin resistant Staphylococcus aureus,MRSA)占分离的金黄色葡萄球菌48.1%。真菌、非结核分枝杆菌及嗜血杆菌等病原菌的检出率逐渐增多,应引起临床微生物工作者和临床医生的高度重视。结论金黄色葡萄球菌依然是关节感染的首位病原菌,其中接近一半为MRSA,提示需采取措施有效防范MRSA蔓延,同时应重视真菌、非结核分枝杆菌及嗜血杆菌等病原菌引起的关节感染。

Objective The pathogens and antimicrobial susceptibility tests were carried out on the positive specimens of synovial fluid culture from 2014 to 2017 to obtain the distribution and drug resistance of pathogens in joint infection.Methods Samples of joint fluid culture in Third Hospital of Hebei Medical University were collected from 2014 to 2017.Identification and drug sensitivity test were carried out with BioMerieuxVitek2 compactSome strains were identified by using 16 S rRNA gene sequence analysis.Some antimicrobial susceptibility tests were done by using E-test and K-B method.Excel and WHONET software were used to collect and analyze the results.Results Staphylococcus aureus(37.50%)was the most common pathogen in the hospital, followed by coagulase negative staphylococci(15.35%,).Escherichia coli, Pseudomonas aeruginosa and Enterobacter cloacae accouted for 9.9%,8.87% and 4.44%,respectively.MRSA(methicillin resistant staphylococcus aureus) accounted for 48.1% of all Staphylococcus aureus.The detection rate of pathogens such as fungi, non tuberculous mycobacteria and Haemophilus influenzae was increased gradually, which should be paid more attention by clinical microbiologist and clinicians.Conclusion Staphylococcus aureus is joint top of pathogen infection, nearly half of MRSA,prompt measures should be taken to prevent the spread of MRSA effectively, at the same time should pay attention to the fungus, non mycobacterium tuberculosis and haemophilus pathogen infection caused by joints.