摘要
目的对骨科伤口采样培养,进行病原菌分布和耐药情况分析,为临床合理使用抗菌药物提供依据。方法回顾性分析本院骨科2015年至2018年送检伤口分泌物的细菌培养及药敏结果。结果2835份标本中,细菌培养阳性516例,阳性率为18.20%;其中格兰阴性杆菌291例,占56.40%,主要为铜绿假单胞菌、阴沟肠杆菌、大肠埃希菌、肺炎克雷伯菌。革兰阳性球菌212例,占41.09%,主要为金黄色葡萄球菌、溶血性葡萄球菌、粪肠球菌;真菌13例,占2.51%。金黄色葡萄球菌对多种抗菌药物敏感率良好,其中对利奈唑胺、替加环素、替考拉宁和万古霉素的敏感率达到100%,革兰阴性杆菌中铜绿假单胞菌和肺炎克雷伯菌的耐药情况良好,但对大肠埃希菌和阴沟肠杆菌的耐药情况较严重,对多种抗菌药物的耐药率达50%,特别是阴沟肠杆菌对头孢类抗菌药物的耐药率可达100%。结论骨科感染患者的病原菌分布情况复杂,耐药形势仍很严峻,应采取更加积极有效的措施控制耐药菌的增多与传播。
Objective To analyze the distribution and drug resistance of pathogenic bacteria by sampling and culture the secretion of wounds in orthopedics,so as to provide basis for clinical rational use of antibacterial drugs.Methods The bacterial culture and drug sensitivity results of wound secretions submitted by Orthopedics Department of our hospital from 2015 to 2018 were retrospectively analyzed.Results Among the 2835 specimens,516 were positive for bacterial culture,with positive rate of 18.20%.Among them,there were 291 cases(56.40%)for Gram negative bacilli,mainly including Pseudomonas aeruginosa,Enterobacter cloacae,Escherichia coli and Klebsiella pneumoniae.212 cases(41.09%)were Gram-positive cocci,mainly including Staphylococcus aureus,coagulase negative Staphylococci and Enterococcus faecalis.In addition,there were 13 cases of fungi,accounting for 2.51%.Staphylococcus aureus had good sensitivity to various antibacterial drugs.Among them,the sensitivity rate to linezolid,tigecycline,teicoplanin and vancomycin reached 100%,and the drug resistance of Pseudomonas aeruginosa and Klebsiella pneumoniae in Gram-negative bacilli was good.However,there was severe drug resistance for Escherichia coli and Enterobacter cloacae,and their drug resistance rate to various antibacterial drugs could reach 50%,especially the drug resistance rate of Enterobacter cloacae to cephalosporins can reach 100%.Conclusion The distribution of pathogenic bacteria for patients with wound infection in orthopedics is complex,and the drug resistance situation remains still to be serious.More active and effective measures should be taken to control the increase and spread of drug-resistant bacteria.
作者
余飞燕
郑若玲
YU Feiyan;ZHENG Ruoling(Department of Clinical Laboratory,Yangjiang Hospital of Traditional Chinese Medicine,Yangjiang,Guangdong,China,529500)
出处
《当代医学》
2021年第13期72-75,共4页
Contemporary Medicine
关键词
骨科
伤口分泌物
病原菌
耐药率
Orthopedics
Wound secretions
Pathogenic bacteria
Drug resistance rate
