120例骨科创伤伤口感染患者的病原菌分布与耐药性分析

Distribution and drug resistance analysis of pathogenic bacteria in 120 cases of orthopedic trauma wound infection

目的分析骨科创伤伤口感染的病原菌分布及其耐药性。方法回顾性分析120例骨科创伤伤口感染情况,采用《全国临床检验操作规程》标准分离培养病原菌,采用VITEK 2紧凑型自动细菌鉴定和药物敏感性分析系统进行细菌鉴定,药敏试验采用纸片扩散法(K-B法),根据抑制区直径判断结果,分析病原菌分布情况及耐药性。结果120例患者共培养出148株病原菌,其中革兰阴性菌102株(68.92%),革兰阳性菌43株(29.05%),真菌3株(2.03%)。大肠埃希菌对亚胺培南的耐药率为0;对头孢哌酮/舒巴坦钠、美罗培南均具有良好的敏感性,耐药率分别为8.33%、13.89%。铜绿假单胞菌对亚胺培南的耐药率为4.00%;对氨曲南及美罗培南基本敏感,耐药率分别为8.00%、12.00%;对头孢西丁、左氧氟沙星敏感性差,耐药率分别为92.00%、88.00%。主要革兰阳性细菌对利奈唑胺、万古霉素、呋喃妥因高度敏感,耐药率均为0;对氨苄西林耐药率为100.00%。其他抗菌药物中,金黄色葡萄球菌对四环素耐药率较高为86.67%;其次为庆大霉素和氯霉素,耐药率均为80.00%。表皮葡萄球菌对四环素耐药率较高为90.91%,其次为左氧氟沙星和氧氟沙星,耐药率均为81.82%。结论骨科创伤伤口感染应严格根据药物敏感性选择抗菌药物,以减少细菌耐药性的发生。

Objective To analyze the distribution and drug resistance analysis of pathogenic bacteria in 120 cases of orthopedic trauma wound infection.Methods The wound infection of 120 orthopedic trauma patients was retrospectively analyzed.Isolated and cultured pathogenic bacteria using the standard of National Clinical Laboratory Practice,and used the VITEK 2 compact automatic bacterial identification and drug susceptibility analysis system for bacterial identification,and the drug susceptibility test was performed by the Kirby-Bauer method(K-B method),and the results were judged according to the diameter of the zone of inhibition to analyze the distribution and drug resistance of pathogenic bacteria.Results A total of 148 strains of pathogenic bacteria were cultured in 120 patients,including 102 strains(68.92%)of Gram-negative,43 strains(29.05%)of Gram-positive and 3 strains(2.03%)of fungus.The resistance rate of Escherichia coli to imipenem was 0;they had good susceptibility to cefoperazone/sulbactam sodium and meropenem,with resistance rates of 8.33%and 13.89%,respectively.Pseudomonas aeruginosa was 4.00%resistant to imipenem;it was basically sensitive to aztreonam and meropenem,with resistance rates of 8.00%and 12.00%,respectively;it was poorly sensitive to cefoxitin and levofloxacin,with resistance rates of 92.00%and 88.00%,respectively.The major Gram-positive bacteria were highly sensitive to linezolid,vancomycin and furantoin,and the resistance rate was 0;the resistance rate to ampicillin was 100.00%.Among other antibacterial drugs,Staphylococcus aureus had a high resistance rate of 86.67%to tetracycline;followed by gentamicin and chloromycetin,both with a resistance rate of 80.00%.Staphylococcus epidermidis had a high resistance rate of 90.91%to tetracycline,followed by levofloxacin and ofloxacin,both with a resistance rate of 81.82%.Conclusion In orthopaedic trauma wound infections,antibacterial drugs should be selected strictly according to drug sensitivity to reduce the occurrence of bacterial resistance.