摘要
目的分析骨折相关性感染(fracture related infection,FRI)患者的病原菌谱及其药物敏感性,为临床预防及治疗FRI提供参考。方法收集2018年6月至2024年6月南京大学医学院附属鼓楼医院收治的190例FRI患者,其中男142例,女48例;年龄15~91岁,平均(52.29±14.65)岁。对FRI患者深部组织分泌物进行病原菌培养及药敏试验,对阳性结果进行统计分析。结果190例患者中,培养结果阴性76例,阳性114例,阳性率60.00%。114例阳性患者中,单种感染107例,混合感染7例。检出病原菌19种(共124株),其中革兰氏染色阳性菌7种(共70株,占比56.45%),革兰氏染色阴性菌11种(共53株,占比42.74%),真菌感染1种(1株,占比0.81%)。药敏结果显示多重耐药菌(multiple resistance bacteria,MDR)29株(23.39%),其中2株肺炎克雷伯杆菌存在超广谱β-内酰胺酶(extended spectrum beta-lactamases,ESBLs)耐药机制。结论本研究纳入的FRI患者以单一病原菌感染为主,其中革兰氏阳性菌占比较大;病原菌耐药性、MDR占比与既往研究结果相似。根据药敏试验结果合理选择抗生素,减少抗生素的滥用对FRI的治疗至关重要。
Objective To analyze the pathogen spectrum and antibiotic susceptibility in patients with fracture-related infection(FRI),providing evidence for clinical prevention and treatment.Methods We retrospectively collected 190 consecutive FRI patients treated at our hospital between June 2018 and June 2024;142 were male and 48 female,aged 15~91 years[mean(52.29±14.65)years].Deep-tissue specimens were cultured and subjected to antimicrobial susceptibility testing.Positive results were statistically analyzed.Results Of the 190 cases,114 were culture-positive(positivity rate 60.00%)and 76 were negative.Among the 114 positive cases,107 showed monomicrobial infection and 7 polymicrobial infection.A total of 19 pathogen species(124 strains)were isolated:7 Gram-positive species(70 strains,56.45%),11 Gram-negative species(53 strains,42.74%),and 1 fungal species(1 strain,0.81%).Antimicrobial susceptibility testing revealed 29 multidrug-resistant(MDR)strains(23.39%),including two Klebsiella pneumoniae strains producing extended-spectrum β-lactamases(ESBLs).Conclusion Monomicrobial infection was predominant in our FRI cohort,with Gram-positive bacteria accounting for the largest proportion.The resistance profile and MDR rate were similar to previous findings.Rational antibiotic selection guided by susceptibility testing is essential for effective FRI management and for reducing antibiotic misuse.
作者
唐一凡
戚晓阳
邱旭升
陈一心
Tang Yifan;Qi Xiaoyang;Qiu Xusheng;Chen Yixin(Department of Orthopaedics,Affiliated Drum Tower Hospital,Medical School,Nanjing University,Nanjing 210008,China)
出处
《实用骨科杂志》
2025年第7期600-603,608,共5页
Journal of Practical Orthopaedics
基金
南京市卫生局重点项目(ZKX21029)。
关键词
骨折相关性感染
病原菌谱
耐药性
药敏试验
fracture related infection
pathogen spectrum
drug resistance
antibiotic susceptibility testing
