骨伤患者伤口感染病原菌构成和耐药谱分析

Composition and Drug Resistance Spectrum Analysis of Pathogenic Bacteria from the Wounds of Bone Trauma Patients

【目的】调查骨伤患者伤口感染病原菌的构成及其耐药情况。【方法】用VITEK ATB系统对本院2 0 0 2年至 2 0 0 3年间骨伤患者伤口感染病原菌监测资料进行统计分析。【结果】两年来 ,从本院骨伤患者伤口感染分离出的病原菌中 ,革兰阴性杆菌检出率为 5 8.73% ,较革兰阳性球菌 (39.75 % )为高 ;居分离病原菌首位者为金黄色葡萄球菌 ,其次为铜绿假单胞菌。检出耐甲氧西林金黄色葡萄球菌 (MRSA)和耐甲氧西林凝固酶阴性的葡萄球菌 (MRSCON)的比例分别为 39.0 %和 82 .0 % ;主要的革兰阴性杆菌目前对亚胺培南耐药率显著低于其他抗菌药物 (P <0 .0 5 ) ,对阿米卡星耐药率也保持在仅次于亚胺培南的低水平。【结论】骨伤患者伤口感染病原菌的耐药形势严峻 。

To survey the composition and drug resistance of pathogenic bacteria from the wounds of bone trauma patients with infected wounds.VITEK-ATB system was used to analyze statistically the monitoring data of pathogenic bacteria in bone trauma patients with infected wounds from the year 2002 to 2003.Within last two years, the detection rate of Gram-negative(G -) bacilli from the infected wounds of bone trauma patients in our hospital was 58.73%, higher than that of Gram-positive(G +) cocci (39.75%). The predominant one among all pathogenic bacteria was Staphylococcus aureus, Pseudomonas aeruginosa came to the second. The detection rates of methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant Staphylococcus coagulase negative (MRSCON) were 39.0% and 82.0%, respectively; the resistance rate to imipenem among the main G - bacteria was much lower than that to other antibiotics (P<0.05). The resistance rate to amikacin was kept on a level only lower than that to imipenem.[Conclusion]The drug resistance situation of pathogenic bacteria isolated from the wounds of bone trauma patients is very serious, so it is necessary to strengthen the administration of applying antibiotics reasonably.