开放性关节损伤患者感染菌种及耐药性分析

Analysis of bacterial infection species and drug esistance in patients with open joint injury

目的观察关节开放性外伤患者的细菌感染菌种并分析耐药性。方法选取2018年4月-2021年12月于都县人民医院收治的152例关节开放性外伤患者作为研究对象,进行回顾性分析。采集患者创口分泌物,进行细菌培养,检测病原菌并分析药敏试验结果。结果152例关节开放性外伤患者的伤口分泌物样本中,检出病原菌183株,包含革兰阴性杆菌40株,占总数21.86%,其中铜绿假单胞菌与大肠埃希菌最多,分别占总数8.74%、7.65%;革兰阳性球菌139株,占总数75.96%,其中金黄色葡萄球菌、腐生葡萄球菌与表皮葡萄球菌最多,分别占总数32.24%、14.75%、16.39%;真菌4株,占总数2.19%。药敏试验结果显示,铜绿假单胞菌和大肠埃希菌对常用抗菌药物均有不同程度的耐药性,特别是对头孢西丁、甲氧苄啶、氨苄西林等具有较高的耐药性。金黄色葡萄球菌、腐生葡萄球菌、表皮葡萄球菌对常用抗菌药物均有不同程度的耐药性,其中对青霉素的耐药性最高,未检出耐替考拉宁及万古霉素的葡萄球菌。结论预防和控制关节损伤感染,除对开放性关节损伤患者应尽早在无菌操作下进行清创处理外,还应根据细菌培养以及药敏实验结果以确定所使用的抗生素,及时对病灶进行手术引流。

Objective Bacterial infection strains were observed in patients with open joint trauma and analyzed for drug resistance.Methods A total of 152 patients with open joint trauma admitted from April 2018 to December 2021 were selected as the study subjects for retrospective analysis.Patient wound secretions were collected,bacterial cultures,tested for pathogens and analyzed the drug susceptibility test results.Results Among the wound secretion samples of 152 patients with open joint trauma,183 pathogens were detected,including 40 gram-negative bacteria,accounting for 21.86%,among which Pseudomonas aeruginosa and E. coli were 8.74% and 7.65%,139 gram-positive coccal bacteria,accounting for 75.96%,including S. aureus,saprophyte and S. epidermidis,accounting for 32.24%,14.75% and 16.39%,and 4 fungi,accounting for2.19%.The results of drug susceptibility test showed that both P. aeruginosa and E. coli showed varying degrees of resistance to commonly used antimicrobial drugs, especially to cefoxidine,trimethoprim,ampicillin,etc.Staphylococcus aureus,Staphylococcus saprophytic,and Staphylococcus epidermidis all had different degrees of resistance to commonly used antimicrobial drugs,among which the resistance to penicillin was highest,and no Staphylococcus resistant to surrogate olanin and vancomycin were detected.Conclusion To prevent and control the joint injury infection,in addition to the patients with open joint injury should be treated under aseptic operation as soon as possible,according to the bacterial culture and drug sensitivity experiment results to determine the antibiotics used.