Incisional Negative Pressure Wound Therapy in the Prevention of Surgical Site Infection after Vascular Surgery with Inguinal Incisions: Rationale and Design of a Randomized Controlled Trial (INVIPS-Trial)

Background/Aims: Inguinal incisions are a common route of access in vascular surgery. Due to anatomical challenges and a diverse bacterial flora in this area, surgical site infections (SSI) represent a common, debilitating and sometimes life-threatening complication. The INVIPS-Trial evaluates the role of Negative Pressure Wound Therapy (NPWT) on closed inguinal incisions in elective vascular surgery to prevent SSI and other wound complications. Methods: This randomized controlled trial (RCT) registered at ClinicalTrials.gov (Identifier: NCT01913132) compares the effects of a NPWT dressing (PICO, Smith & Nephew, UK) and the center’s standard wound dressing (Vitri Pad, ViTri Medical, Sweden) on postoperative wound complications, especially SSI. The study includes two distinct vascular procedures with different SSI risk profiles: endovascular aortic repair (EVAR) and open surgical approaches involving the common femoral artery (OPEN). Results: Four hundred ninety-five groin incisions in both treatment arms are anticipated to be included in the EVAR group and 147 inguinal incisions in both treatment arms in the OPEN group. Since a large percentage of inguinal vascular procedures in both groups but especially in the EVAR group are performed bilaterally, many patients can serve as their own control by randomly receiving NPWT on one and the standard dressing on the contralateral inguinal incision. Conclusions: This ongoing RCT attempts to elucidate the potential benefit of NPWT on closed inguinal incisions after different vascular procedures. Outcome and conclusions of this trial could have implications on postoperative wound care of patients in both vascular surgery and other surgical specialties.

Research progress in urinary tract infection and its therapeutic drugs

Objective: The objective of this study was to understand the pathological mechanism and therapeutic progress in the study of urinary tract infections to provide references for clinical diagnosis and identification and development of therapeutic drugs.Methods: We summarized the types, pathological mechanisms, and therapeutic drugs for urinary tract infections on the basis of recent publications on these infections, both domestic and abroad.Results and conclusions: Urinary tract infection is mainly caused by pathogenic bacterial infection and treated by targeting bacterial adhesion, bacterial toxin, protease, urease, and siderophores, as well as using pili as vaccines and small-molecule drugs. Vaccines that target bacterial adhesion can block well the interaction between pathogens and the body, thereby reducing the incidence of urinary tract infections. The clinical efficacy of vaccines targeting bacterial toxins and proteases needs further evaluation. Vaccines targeting iron carriers retard disease progression and attenuate bacterial colonization. Urease-targeted small-molecule drugs exhibit certain curative effects and serious side effects. Small pili-targeted drugs can prevent and treat urinary tract infections by blocking the colonization and invasion of pathogens in animal models of urinary tract infections on the bladder. Adhesive FimH antibodies have entered Phase Ⅰ clinical trials. However, pilicides, mannosides, and vaccines that target pili, iron carriers, and other virulence factors are still in the experimental or preclinical stages of research.

Current therapeutic strategies for recurrent hepatitis B virus infection after liver transplantation

Hepatitis B virus (HBV)-related liver disease is the leading indication for liver transplantation (LT) in Asia,especially in China.With the introduction of hepatitis B immunoglobulin (HBIG) and oral antiviral drugs,the recurrent HBV infection rate after LT has been evidently reduced.However,complete eradication of recurrent HBV infection after LT is almost impossible.Recurrent graft infection may lead to rapid disease progression and is a frequent cause of death within the fi rst year after LT.At present,the availability of new oral medications,especially nucleoside or nucleotide analogues such as adefovir dipivoxil,entecavir and tenofovir disoproxil fumarate,further strengthens our ability to treat recurrent HBV infection after LT.Moreover,since combined treatment with HBIG and antiviral agents after liver re-transplantation may play an important role in improving the prognosis of recurrent HBV infection,irreversible graft dysfunction secondary to recurrent HBV infection in spite of oral medications should no longer be considered an absolute contraindication for liver re-transplantation.Published reviews focusing on the therapeutic strategies for recurrent HBV infection after LT are very limited.In this article,the current therapeutic strategies for recurrent HBV infection after LT and evolving new trends are reviewed to guide clinical doctors to choose an optimal treatment plan in different clinical settings.

Management of psoriasis patients with hepatitis B or hepatitis C virus infection

The systemic therapies available for the management of Psoriasis (PsO) patients who cannot be treated with more conservative options, such as topical agents and/or phototherapy, with the exception of acitretin, can worsen or reactivate a chronic infection. Therefore, before administering immunosuppressive therapies with either conventional disease-modifying drugs (cDMARDs) or biological ones (bDMARDs) it is mandatory to screen patients for some infections, including hepatitis B virus (HBV) and hepatitis C virus (HCV). In particular, the patients eligible to receive an immunosuppressive drug must be screened for the following markers: antibody to hepatitis B core, antibody to hepatitis B surface antigen (anti-HBsAg), HBsAg, and antibody to HCV (anti-HCV). In case HBV or HCV infection is diagnosed, a close collaboration with a consultant hepatologist is needed before and during an immunosuppressive therapy. Concerning therapy with immunosuppressive drugs in PsO patients with HBV or HCV infection, data exist mainly for cyclosporine a (CyA) or bDMARDs (etanercept, adalimumab, infliximab, ustekinumab). The natural history of HBV and HCV infection differs significantly as well as the effect of immunosuppression on the aforementioned infectious diseases. As a rule, in the case of active HBV infection, systemic immunosuppressive antipsoriatic therapies must be deferred until the infection is controlled with an adequate antiviral treatment. Inactive carriers need to receive antiviral prophylaxis 2-4 wk before starting immunosuppressive therapy, to be continued after 6-12 mo from its suspension. Due to the risk of HBV reactivation, these patients should be monitored monthly for the first 3 mo and then every 3 mo for HBV DNA load together with transaminases levels. Concerning the patients who are occult HBV carriers, the risk of HBV reactivation is very low. Therefore, these patients generally do not need antiviral prophylaxis and the sera HBsAg and transaminases dosing can be monitored every 3 mo. Concerning PsO patients with chronic HCV infection their management with immunosuppressive drugs is less problematic as compared to those infected by HBV. In fact, HCV reactivation is an extremely rare event after administration of drugs such as CyA or tumor necrosis factor-α inhibitors. As a rule, these patients can be monitored measuring HCV RNA load, and ALT, aspartate transaminase, gamma-glutamyl-transferase, bilirubin, alkaline phosphatase, albumin and platelet every 3-6 mo. The present article provides an updated overview based on more recently reported data on monitoring and managing PsO patients who need systemic antipsoriatic treatment and have HBV or HCV infection as comorbidity.

Role of negative pressure wound therapy in total hip and knee arthroplasty

Negative-pressure wound therapy(NPWT) has been a successful modality of wound management which is in widespread use in several surgical fields. The main mechanisms of action thought to play a role in enhancing wound healing and preventing surgical site infection are macrodeformation and microdeformation of the wound bed, fluid removal, and stabilization of the wound environment. Due to the devastating consequences of infection in the setting of joint arthroplasty, there has been some interest in the use of NPWT following total hip arthroplasty and total knee arthroplasty. However, there is still a scarcity of data reporting on the use of NPWT within this field and most studies are limited by small sample sizes, high variability of clinical settings and end-points. There is little evidence to support the use of NPWT as an adjunctive treatment for surgical wound drainage, and for this reason surgical intervention should not be delayed when indicated. The prophylactic use of NPWT after arthroplasty in patients that are at high risk for postoperative wound drainage appears to have the strongest clinical evidence. Several clinical trialsincluding single-use NPWT devices for this purpose are currently in progress and this may soon be incorporated in clinical guidelines as a mean to prevent periprosthetic joint infections.

Therapeutic and prevention strategies against human enterovirus 71 infection

Human enterovirus 71(HEV71) is the cause of hand,foot and mouth disease and associated neurological complications in children under five years of age.There has been an increase in HEV71 epidemic activity throughout the Asia-Pacific region in the past decade,and it is predicted to replace poliovirus as the extant neurotropic enterovirus of highest global public health significance. To date there is no effective antiviral treatment and no vaccine is available to prevent HEV71 infection. The increase in prevalence, virulence and geographic spread of HEV71 infection over the past decade provides increasing incentive for the development of new therapeutic and prevention strategies against this emerging viral infection. The current review focuses on the potential, advantages and disadvantages of these strategies. Since the explosion of outbreaks leading to large epidemics in China, research in natural therapeutic products has identified several groups of compounds with anti-HEV71 activities. Concurrently, the search for effective synthetic antivirals has produced promising results. Other therapeutic strategies including immunotherapy and the use of oligonucleotides have also been explored. A sound prevention strategy is crucial in order to control the spread of HEV71. To this end the ultimate goal is the rapid development, regulatory approval and widespread implementation of a safe and effective vaccine. The various forms of HEV71 vaccine designs are highlighted in this review. Given the rapid progress of research in this area, eradication of the virus is likely to be achieved.

Systematic review of the negative pressure wound therapy in kidney transplant recipients

AIM To review negative pressure wound therapy(NPWT) as animportant addition to the conventional methods of wound management.METHODS A systematic review, performed by searching the PubM ed, EMBASE and Cochrane Library databases, showed 11 case reports comprising a total of 22 kidney transplantation(KT) patients(range, 1 to 9), who were treated with NPWT. Application of NPWT was associated with successful healing of wounds, leg ulcer, lymphocele and urine leak from ileal conduit.RESULTS No complications related to NPWT were reported. However, there was paucity of robust data on the effectiveness of NPWT in KT recipients; therefore, prospective studies assessing its safety and efficacy of NPWT and randomised trials comparing the effectiveness of NPWT with alternative modalities of wound management in KT recipients is recommended.CONCLUSION Negative pressure incision management system, NPWT with instillation and endoscopic vacuum-assisted closure system are in investigational stage.

造血干细胞移植后并发阿萨希毛孢子菌血流感染1例并文献复习

目的:探讨血液恶性肿瘤患儿造血干细胞移植后发生阿萨希毛孢子菌血流感染的治疗药物选择。方法:分析1例造血干细胞移植后处于免疫抑制状态下血流感染阿萨希毛孢子菌的病例资料,结合既往文献,讨论并分析阿萨希毛孢子菌血流感染的药物治疗方案。结果:患儿在艾沙康唑治疗过程中发生了阿萨希毛孢子菌血流感染,调整为伏立康唑和两性霉素B脂质体联合治疗后,体温恢复正常,炎性指标好转,但由于患儿移植后出现了严重的肺部排斥反应,肺出血未能得到有效控制,最终放弃治疗。结论:血液恶性肿瘤患儿血流感染阿萨希毛孢子菌病死率高,在临床实践中应结合病情、体外药敏试验结果选择单药或联合治疗。阿萨希毛孢子菌应首选唑类药物,体外活性最强的是伏立康唑。两性霉素B抗真菌活性不充分,但与伏立康唑的联合治疗方案可能较伏立康唑单药或艾沙康唑单药治疗更具优势。

负压引流辅助治疗骨与软组织感染的机制

背景:随着国内人口老龄化进程的加快,骨与软组织感染的发病率也随之升高。骨与软组织感染可累及包括骨膜、骨皮质、骨松质和骨髓在内的所有骨组织及周围软组织,如糖尿病足、骨髓炎、手术切口感染和关节假体周围感染等均属此范畴,由于其发病机制复杂且治疗困难,因而越来越受到临床关注。负压创面治疗技术是近年来用于伤口治疗的新兴技术,尤其在骨与软组织感染领域疗效显著。目的:综述近年国内外负压创面治疗技术治疗骨与软组织感染的研究进展。方法:检索1990-2022年在PubMed、Web of Science数据库和中国知网发表的相关中英文文献,英文检索词“negative pressure wound therapy,vacuum assisted closure,negative pressure,osteomyelitis,bone infection”;中文检索词“负压伤口疗法,局部负压疗法,负压包扎,负压封闭技术,机械力,骨髓炎,骨感染”。共检索到711篇相关文献,其中65篇文献符合纳入标准。结果与结论:①负压创面治疗技术作为一种创面辅助治疗方式,相对于单一作用的传统敷料,其稳定创面、减轻水肿、降低细菌载荷、刺激肉芽组织和血管生成、改善组织灌注、调控末梢神经、调节生物免疫、促进成骨细胞增殖和分化的多重作用机制,能够更好地管理骨与软组织感染等复杂创面;②现有的大量基础及临床研究结果表明负压创面治疗技术在辅助治疗骨与软组织感染中具有显著的安全性及有效性。

抗新型冠状病毒小分子药物临床应用专家共识

新型冠状病毒(新冠病毒)感染虽已不再构成“国际关注的突发公共卫生事件”,但仍在全球范围内处于低水平流行。小分子口服药物是我国目前推荐的针对新冠病毒感染的主要抗病毒治疗方案。虽然国内已上市多种抗新冠病毒小分子药物,但目前尚无针对特殊人群的具体用药推荐。中华医学会细菌感染与耐药防治分会联合国家呼吸医学中心、国家呼吸系统疾病临床医学研究中心组织国内呼吸、病毒学、感染、重症、急诊、药学等各领域专家制订了本共识。本共识的主要内容包括7种抗新冠病毒小分子药物介绍,重点阐述了老年人群、合并慢性疾病人群、肿瘤患者、孕妇、儿童等14种特殊人群用药推荐,为临床医师规范用药提供建议。

复方黄柏液联合磺胺嘧啶银乳膏对烧伤合并多重耐药菌创面感染患者创面愈合及炎性因子的影响

目的探讨复方黄柏液联合磺胺嘧啶银乳膏对烧伤合并多重耐药菌(MDROS)创面感染患者创面愈合及炎性因子的影响。方法选取2019年7月—2022年1月本院收治的86例烧伤合并MDROS创面感染患者,采用数字奇偶法分为对照组(给予磺胺嘧啶银乳膏治疗)和观察组(给予复方黄柏液联合磺胺嘧啶银乳膏治疗),每组各43例。比较2组患者创面中医症状评分、创面面积、创面愈合率、炎性因子[降钙素原(PCT)、C反应蛋白(CRP)]水平、创面分泌物细菌培养结果和不良反应。结果治疗后观察组主症、次症评分及总分均低于对照组(P<0.05),观察组总有效率高于对照组(P<0.05);治疗后观察组创面面积低于对照组(P<0.05),观察组创面愈合率高于对照组(P<0.05);治疗后观察组PCT和CRP水平均低于对照组(均P<0.05);治疗后观察组革兰阳性菌、革兰阴性菌感染病例数低于对照组(P<0.05);2组不良反应发生率相近(P>0.05)。结论烧伤合并MDROS创面感染患者采用复方黄柏液、磺胺嘧啶银乳膏联合治疗有利于促进创面愈合,降低炎性因子水平,控制创面细菌感染,缓解临床症状,提高临床疗效,且安全可靠。

心脏植入式电子装置感染的诊治进展

随着心血管疾病发生率逐渐升高,心脏植入式电子装置(cardiac implantable electronic device, CIED)在临床治疗中的应用越来越广泛,CIED感染的发病率也随之升高。目前国际各大指南及共识均推荐CIED感染发生后应尽早彻底移除整个装置系统(包括脉冲发生器和电极),然而拔除电极的技术难度及风险较大,部分患者因生理或心理因素无法完成相关手术治疗,因此正确认识感染的发生机制、危险因素、治疗和预防,对临床正确处理CIED感染有重要意义。本文就近年CIED感染诊治进展进行综述。

乙型肝炎病毒感染机制和药物治疗的研究进展

乙型肝炎病毒感染成为全球疾病负担重要原因之一,目前仍缺乏彻底根治的方法。近年来,各类研究分别从抗病毒治疗和增强宿主免疫应答两方面进行药物设计,使得乙型肝炎病毒感染治疗领域快速发展。通过梳理相关文献,本文较为系统、全面地探讨了乙型肝炎病毒的感染机制和药物治疗进展。本文表明,在抗病毒治疗过程中,核苷(酸)类似物、核衣壳组装调节剂、HBx蛋白抑制剂、核糖核酸酶H抑制剂、NTCP相关抑制剂、HBsAg释放抑制剂等药物的设计与病毒生命周期的潜在靶点环环相扣,治疗关键在于彻底清除共价闭合环状DNA病毒源库;在增强宿主免疫应答过程中,通过包括免疫检查点抑制剂、Toll样受体激动剂和干扰素制剂修复和增强患者受损的免疫应答机制,实现抑制病毒复制的治疗目标。总之,乙肝病毒感染的药物治疗之路不断向前发展中。本文以期能够为该领域的研究提供一定思路。

负压伤口疗法预防肝癌切除术后患者切口感染的效果及其对切口愈合质量及血清炎性因子的影响

目的:探讨负压伤口疗法(Negative-pressure wound therapy,NPWT)预防肝癌切除术后患者切口感染的效果及其对切口愈合质量及血清炎性因子的影响。方法:选取2020年1月至2022年12月期间我院收治的80例肝癌切除术后患者作为研究对象,按照随机数字表法分为对照组和观察组,各40例。对照组患者在术后接受常规伤口疗法,观察组在术后接受NPWT。观察两组患者康复情况、术后切口恢复效果、炎性因子、术后并发症。结果:观察组患者拆线时间及住院治疗时间均明显短于对照组患者(P<0.05);观察组患者创面新鲜肉芽组织生长时间及切口愈合时间均明显短于对照组(P<0.05);治疗后观察组患者炎性因子水平瘤坏死因子-α(Tumour necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)均明显低于对照组(P<0.05);观察组术后并发症发生率明显低于对照组(P<0.05)。结论:对肝癌切除术后患者采用负压伤口疗法可缩短患者拆线及住院时间,促进患者术后恢复,改善炎症水平、减少切口感染等并发症。

Effect of drug therapies on self-reported chemosensory outcomes after COVID-19

Objective:The aim of this study was to assess the relative efficacy of medications used following severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection on self-reported alterations in taste and/or smell function.Methods:Seven hundred and fourteen persons with self-reported postcoronavirus disease 2019(post-COVID-19)chemosensory disorders were personally interviewed regarding specific medications they were administered following the acute phase of the disease.The dependent measure—self-reported total recovery of chemosensory symptoms—was subjected to stepwise logistic regression.Independent predictors included demographic and clinical variables,in addition to specific medications used to mitigate disease symptoms(i.e.,systemic corticosteroids,oseltamivir,vitamin C,ibuprofen,hydroxychloroquine,azithromycin,ivermectin,nitazoxanide,anticoagulants,and zinc).Results:The median time between COVID-19 symptom onset and the interviews was 81 days(interquartile range:60-104).Of the 714 subjects,249(34.9%)reported total recovery of their chemosensory function;437(61.2%)had at least one treatment since the beginning of the disease.Women and those with more comorbidities had undergone more treatments.The recovery rates of the treated and nontreated groups did not differ significantly.Nonetheless,respondents who had used nitazoxanide tended to have a higher rate of self-reported taste or smell recovery.Those who took oral zinc were less likely to improve.Conclusions:No medication employed during the first months after SARS-CoV-2 infection had a clear positive effect on returning self-reported smell or taste function to normal,although nitrazoxide trended in a positive direction.Oral zinc had a negative effect on the reported recovery of these senses.

Metformin capped Cu_(2)(OH)_(3)Cl nanosheets for chemodynamic wound disinfection

Recently,the development of chemodynamic therapy(CDT)offers a potential approach for fighting bacteria and treating infectious diseases,in which those CDT nanoagents can catalyze the generation of hydroxyl radicals(·OH)to destroy bacteria.In this work,to improve the efficiency of CDT,we have designed a new kind of metformin(Met)-capped two-dimensional Cu_(2)(OH)_(3)Cl nanosheets(CuOHCl-Met NSs)with good monodispersity,highly positive charge,and good biocompatibility for improving antibacterial effect and accelerating wound healing.With the capped Met,CuOHCl-Met NSs can effectively kill bacteria under a low concentration(6μg·mL^(−1))and a short treatment time(in 15 min),showing great advantages over the counterpart without Met.In vivo results demonstrated that CuOHCl-Met NSs accelerated the tissue regeneration of staphylococcus aureus-infected dermal wounds.This study provides a new pathway for improving efficiency of CDT nanoagent through using old drug.

不同烧伤面积患者创面感染病原菌特点及耐药性研究

目的分析不同烧伤面积患者创面感染病原菌特点及耐药性,为临床诊治提供依据。方法对168例烧伤患者进行病原菌检测和药敏试验,统计总体病原菌检出情况,并分析不同烧伤面积患者病原菌检出情况及耐药性。结果168例烧伤患者,创面分泌物共培养出179株菌株,其中烧伤面积<10%(44例)、10%~49%(49例)、≥50%(75例)患者分别检出菌株47株、52株、80株。创面感染病原菌主要为革兰阴性菌(51.96%),其次为革兰阳性菌(48.04%),致病菌株以铜绿假单胞菌(27.37%)、金黄色葡萄球菌(22.91%)为主。烧伤面积<10%、10%~49%、≥50%的患者,主要致病菌分别为金黄色葡萄球菌(48.94%)、铜绿假单胞菌(25.00%)、铜绿假单胞菌(32.50%)。烧伤面积<10%的患者,铜绿假单胞菌对头孢他啶、头孢吡肟、妥布霉素耐药性较高;烧伤面积为10%~49%患者,铜绿假单胞菌对哌拉西林耐药性较高;烧伤面积≥50%的患者,铜绿假单胞菌对哌拉西林、亚胺培南、美罗培南耐药性高。不同烧伤面积患者,金黄色葡萄球菌对万古霉素、利奈唑胺无耐药性;烧伤面积<10%和10%~49%的患者,金黄色葡萄球菌对青霉素G耐药性较高;烧伤面积≥50%的患者,金黄色葡萄球菌对红霉素、克林霉素、青霉素G等多种抗菌药物耐药性较高。结论不同烧伤面积患者创面感染病原菌株存在差异,且随着烧伤面积增加,病原菌的耐药性增加。

噬菌体治疗耐药菌肺部感染的研究进展

肺部感染因其高发病率和死亡率对社会造成重大影响,且随着耐药菌的层见叠出,传统抗生素的应用已不能满足临床治疗肺部感染的现状。噬菌体是细菌的天然寄生病毒,可以杀死细菌宿主,因其具有治疗肺部感染的潜力而备受关注。噬菌体治疗包括开发稳定的噬菌体制剂、进行临床前和临床研究,以评估疗效、药代动力学和安全性。本文基于近几年国内外有关噬菌体治疗的研究报道,从噬菌体制备储存、工程噬菌体、噬菌体临床前和临床研究、噬菌体治疗失败的潜在因素、提高噬菌体疗效的策略等方面进行阐述,并在最后指出了噬菌体治疗仍需解决的问题,旨在为未来噬菌体的抗菌研究及临床应用提供参考。

创面感染病原菌分布及对常用抗菌药物敏感性分析

目的:分析创面感染病原菌分布及对常用抗菌药物的敏感性,从而为创面感染的治疗选择更加安全高效的抗菌药物,保障治疗效果。方法:选择2021年1月—2022年12月荆州市第三人民医院收治的292例创面感染患者纳入研究,应用Levin法采集患者的伤口分泌物,并将采集的标本转送至微生物室做分泌物培养+药敏试验,统计分析患者病原微生物分布及抗菌药物敏感性。结果:共培养出236株病原微生物,其中有82株革兰阳性菌,占总数34.75%;150株革兰阴性菌,占总数的63.56%;念珠菌4株,占总数的1.69%。药敏检测结果显示,金黄色葡萄球菌、表皮葡萄球菌对万古霉素、利奈唑胺、利福平的敏感性较高,对青霉素、红霉素、克林霉素的敏感性偏低。大肠埃希菌对亚胺培南、头孢吡肟、哌拉西林/他唑巴坦敏感性较高,对头孢曲松、左氧氟沙星、头孢他啶、庆大霉素的敏感性偏低;肺炎克雷伯菌对亚胺培南、头孢吡肟、阿米卡星敏感性较高,对头孢曲松、头孢他啶、庆大霉素的敏感性偏低;铜绿假单胞菌对亚胺培南、哌拉西林/他唑巴坦敏感性较高,对头孢曲松、头孢他啶、庆大霉素的敏感性偏低。结论:创面感染患者的病原菌种类较多,不同类型的抗生素对病原菌敏感性各不相同,临床应加强病原菌药敏试验,并根据具体情况可选择联合用药方式,以提升感染治疗效果。

外伤感染患者伤口分泌物病原菌分布及耐药性分析

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。