355例伤口分泌物病原菌分布及耐药分析

Pathogen distribution and resistance analysis from 355 cases of wound secretion specimen

目的了解我院创伤患者伤口分泌物病原菌的分布及耐药特征,为临床合理使用抗菌药物、有效控制伤口感染提供依据。方法回顾分析我院2008年1月——2011年12月伤口分泌物标本分离菌分布情况,采用德灵Microscan微生物测试板进行细菌鉴定及药敏试验。结果共分离出224株病原菌,其中革兰氏阴性杆菌125株,革兰氏阳性球菌96株,真菌3株,排前五位的分离菌依次为金黄色葡萄球菌(53株),大肠埃希菌(34株),凝固酶阴性葡萄球菌(31株),肺炎克雷伯菌(17株),铜绿假单胞菌(14株)。药敏结果显示:大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌对阿米卡星、亚胺培南、庆大霉素较为敏感,金黄色葡萄球菌和凝固酶阴性葡萄球菌对利福平、左氧氟沙星和万古霉素敏感。结论我院伤口分泌物分离菌以金黄色葡萄球菌和大肠埃希菌为主。细菌耐药现象严重,临床医师应根据药敏试验结果合理使用抗菌药物。

Objective Study on pathogen distribution and resistance analysis from wound secretion specimen in our hospital for rational use of antibiotics and controlof wound infection.Methods The bacterial distribution and resistance of wound secretion specimen from January 2008 to December 2011 were retrospectively analyzed.bacterial identification and drug sensitivity test were carried out by Microscan auto microbial identification drug sensitivity testing system.Results There were 224 isolatedstains,including gram negative bacilli 125 stains,gram-positive cocci 96 stains,fungi 3 stains.The first five Pathogens were staphylococcus aureus(n = 53),escherichiacoli(n = 34),coagulase negative staphylococci(n = 31),Klebsiella Pneumoniae(n = 17),pseudomonas aeruginosa(n = 14).Escherichia coli,Klebsiella Pneumoniaeand pseudomonas aeruginosa were sensitive to amikacin,imipenem and gentamicin.staphylococcus aureus and coagulase negative staphylococci were sensitive to rifampicin,levofloxacin and vancomycin.Conclusion In our hospital,the mainly isolated stains from wound secretion specimen were staphylococcus aureus and escherichia coli.Drug resistance phnomeno was severe.Therefore,Clinical doctor should rationally use antibiotics according to drug sensitivity testing results.