外伤感染患者伤口分泌物病原菌分布及耐药性分析

Distribution and drug resistance analysis of pathogenic bacteria in wound secretions of patients with traumatic infection

目的:分析外伤感染患者伤口分泌物病原菌分布及耐药性。方法:回顾性分析2020年3月至2022年9月该院收治的210例外伤感染患者的临床资料,采集伤口分泌物进行病原菌培养和药敏试验,分析外伤感染患者伤口分泌物病原菌分布情况及耐药性。结果:210例外伤感染患者伤口分泌物标本共检出246株病原菌,其中革兰阴性菌147株,革兰阳性菌78株,真菌21株;革兰阴性菌以大肠埃希菌、铜绿假单胞菌、阴沟肠杆菌为主;革兰阳性菌以金黄色葡萄球菌、凝固酶阴性葡萄球菌为主;大肠埃希菌对氨苄西林的耐药率最高(87.50%),对亚胺培南、美罗培南均不耐药;铜绿假单胞菌对复方磺胺甲噁唑、米诺环素的耐药率最高(均为100.00%),对左氧氟沙星、头孢他啶、头孢吡肟、亚胺培南、美罗培南的耐药率较低(均<15%);阴沟肠杆菌对氨苄西林的耐药率最高(100.00%),对头孢哌酮、亚胺培南、美罗培南均不耐药;金黄色葡萄球菌、凝固酶阴性葡萄球菌对四环素的耐药率最高(均为100.00%),对万古霉素、替考拉宁、利奈唑胺均不耐药。结论:外伤感染患者伤口分泌物病原菌分布以革兰阴性菌为主,其中大肠埃希菌占比最高,对氨苄西林的耐药率最高。

Objective:To analyze distribution and drug resistance analysis of pathogenic bacteria in wound secretions of patients with traumatic infection.Methods:The clinical data of 210 patients with traumatic infection admitted to the hospital from March 2020 to September 2022 were retrospectively analyzed.The wound secretions were collected for bacterial culture and drug sensitivity test.The distribution and drug resistance of the pathogenic bacteria in the wound secretions of the patients with traumatic infection were analyzed.Results:246 strains of pathogenic bacteria were detected in the wound secretion samples of the 210 patients with traumatic infection,including 147 strains of Gram-negative bacteria,78 strains of Gram-positive bacteria and 21 strains of fungi.Gram-negative bacteria were mainly Escherichia coli,Pseudomonas aeruginosa and Enterobacter cloacae.Gram-positive bacteria were mainly Staphylococcus aureus and coagulase-negative Staphylococcus.The resistance rate of Escherichia coli to Ampicillin was the highest(87.50%),and it was not resistant to Imipenem and Meropenem.The resistance rates of Pseudomonas aeruginosa to Compound sulfamethoxazole and Minocycline were the highest(both 100.00%),and the resistance rates to Levofloxacin,Ceftazidime,Cefepime,Imipenem and Meropenem were lower(all<15%).The resistance rate of Enterobacter cloacae to Ampicillin was the highest(100.00%),and it was not resistant to Cefoperazone,Imipenem and Meropenem.Staphylococcus aureus and coagulase-negative Staphylococcus had the highest resistance rate to Tetracycline(100.00%),and they were not resistant to Vancomycin,Teicoplanin and Linezolid.Conclusions:The distribution of pathogenic bacteria in the wound secretions of the patients with traumatic infection is mainly Gram-negative bacteria,among which Escherichia coli accounts for the highest proportion and has the highest resistance rate to Ampicillin.