骨科患者感染病原菌分布及其药敏性分析

Analysis of distribution and drug sensitivity of pathogenic bacteria in orthopedic patients

目的了解骨科住院患者感染的病原菌分布及其药敏性,为临床合理应用抗菌药提供依据。方法通过回顾性调查方法,对上海某医院骨科医院感染患者送检病原学标本检测资料进行分析。结果调查时段内从该医院骨科住院感染患者送检标本中共分离出病原菌698株,其中革兰阴性菌和革兰阴性菌分别占51.9%和46.3%,假丝酵母菌属占1.9%。分离的感染菌株以金黄色葡萄球菌、大肠埃希菌和肺炎克雷伯菌分居前3位。临床分离的金黄色葡萄球菌对青霉素、红霉素、克林霉素等抗菌药物耐药率均超过50%;大肠埃希菌和肺炎克雷伯菌的超广谱β-内酰胺酶(ESBLs)检出率分别为33.3%和25.8%。结论住院骨科患者感染病原菌中革兰阳性和革兰阴性菌几乎各占50%,检出金黄色葡萄球菌居首位,应加强耐药菌监测。

Objective To investigate the distribution and drug sensitivity of pathogenic bacteria in orthopedic inpatients,and to provide evidence for rational use of antibiotics in clinical practice.Methods Retrospective investigation was used to analyze the data of pathogenic samples from nosocomial infection patients in orthopaedic department of a hospital in Shanghai.Results During the survey period,698 strains of pathogenic bacteria were isolated from the submitted samples of infected inpatients in the orthopaedic department of the hospital,of which 51.9%were Gram-negative bacteria and 46.3%were Gram-negative bacteria,and 1.9%were Candida.The top 3 strains of infection isolates were Staphylococcus aureus,Escherichia coli and Klebsiella pneumoniae.The drug resistance rates of clinical isolates of Staphylococcus aureus to penicillin,erythromycin,lindamycin and other antibiotics were more than 50%;the detection rates of extended spectrumβ-lactamases(ESBLs)in Escherichia coli and Klebsiella pneumoniae were 33.3%and 25.8%,respectively.Conclusion The Gram-positive and Gram-negative bacteria account respectively for nearly half of the infection pathogens in orthopedic inpatients,and the detected Staphylococcus aureus was on the top,so the monitoring of drug resistant bacteria should be strengthened.