伤口分泌物病原菌的分布及耐药性分析

Distribution and drug resistance analysis of pathogenic bacteria in wound secretions

目的分析金华市中心医院伤口分泌物培养标本的病原菌分布及耐药性,为临床伤口感染合理使用抗菌药物及为医院感染监测提供依据。方法收集2021年7月—12月于金华市中心医院就诊并送检伤口分泌物培养患者的临床信息,进行病原菌分布及耐药性分析。结果共有1020例患者送检的1450份伤口分泌物标本,阳性583份,阳性率为40.21%。共检出非重复菌株699株,混合感染占比14.71%。需氧或兼性厌氧菌检出占比89.56%,其中检出率居前2位的细菌为金黄色葡萄球菌(22.84%)和铜绿假单胞菌(10.54%);检出真菌和厌氧菌占比分别为1.43%和9.01%。金黄色葡萄球菌对青霉素G耐药率最高(93.01%),MRSA检出占比30.07%;粪肠球菌耐药率最高的为红霉素(45.24%);肺炎克雷伯菌和大肠埃希菌耐药率较高的均为头孢曲松、头孢呋辛(>40.00%);真菌对常用抗真菌药物的敏感率较高(>80.00%)。结论本院伤口分泌物标本检出率高,病原菌分布广泛,混合感染、厌氧菌感染多见,MRSA占比较高,临床应有针对性的抗感染治疗,并做好床边隔离,防止耐药菌播散。

Objective This paper is to analyze the distribution and its drug resistance of pathogenic bacteria in the wound secretion specimens submitted by Jinhua Central Hospital,so as to provide basis for the rational use of antibiotics in clinical wound infection and for the monitoring of nosocomial infection.Methods The distribution and drug resistance analysis of pathogenic bacteria in wound secretions were carried out on the clinical information of patients admitted to Jinhua Central Hospital for wound secretion culture from July to December 2021.Results A total of 1450 wound secretion samples were collected from1020 patients,and 583 were positive,with a positive rate of 40.21%.A total of 699 non-duplicate strains were detected,and mixed infection accounted for 14.71%.The detection rate of aerobic or/and facultative anaerobic bacteria was 89.56%,among which the top two bacteria were Staphylococcus aureus(22.84%)and Pseudomonas aeruginosa(10.54%).The detection rates of Fungi and anaerobic bacteria were 1.43%and 9.01%,respectively.The drug resistance rate of Staphylococcus aureus to penicillin G was the highest(93.01%),and the detection rate of MRSA was 30.07%.Erythromycin(45.24%)was the most drug resistant to Enterococcus faecalis.The high drug resistance rates of Klebsiella pneumoniae and Escherichia coli were ceftriaxone and cefuroxime(>40.00%).The susceptibility rate of Fungi to commonly used antifungal drugs was higher(>80.00%).Conclusion In this hospital,the detection rate of wound secretion samples is high,and the pathogenic bacteria are widely distributed.Mixed infections and anaerobic infections are more common,and MRSA accounts for a high proportion.Clinical anti-infective treatment should be targeted,and bedside isolation should be done to prevent the spread of drug-resistant bacteria.