骨科患者术后医院感染病原菌与多药耐药菌临床特征分析

发布时间：2018-03-20 23:25

本文选题：医院感染　切入点：骨科手术　出处：《中华医院感染学杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的探讨骨科患者术后医院感染病原菌调查及多药耐药菌临床特征,为控制医院感染提供依据。方法回顾性分析2012年3月-2015年3月医院收治的105例骨科手术后医院感染患者临床资料,记录医院感染部位、病原菌构成,并分析多药耐药菌的分布及对抗菌药物的耐药率;采用Data Trace软件进行统计分析。结果 105例医院感染患者中手术切口感染43例占41.0%,上呼吸道感染27例占25.7%,皮肤软组织感染15例占14.3%;共分离出病原菌197株,其中革兰阳性菌125株占63.5%,革兰阴性菌68株占34.5%,真菌4株占2.0%;197株病原菌中多药耐药菌54株,均为革兰阴性菌;多药耐药铜绿假单胞菌耐药率最高的是头孢噻肟为94.4%,大肠埃希菌耐药率最高的是庆大霉素为87.5%,鲍氏不动杆菌耐药率最高的是头孢噻肟为92.9%。结论骨科患者术后医院感染主要病原菌是革兰阳性菌,在感染病原菌中多药耐药菌所占比例较高,临床应根据药敏试验结果合理选择抗菌药物。
[Abstract]:Objective to investigate the pathogenic bacteria of postoperative nosocomial infection and the clinical characteristics of multidrug resistant bacteria in orthopedic patients. Methods the clinical data of 105 patients with nosocomial infection after orthopedic surgery from March 2012 to March 2015 were analyzed retrospectively. The site of nosocomial infection and the composition of pathogens were recorded. The distribution of multidrug resistant bacteria and the resistance rate to antimicrobial agents were analyzed. Results among the 105 patients with nosocomial infection, 43 had incision infection, 27 had upper respiratory tract infection, and 15 had skin and soft tissue infection, among them 43 had incision infection, 27 had upper respiratory tract infection, and 15 had skin and soft tissue infection, and 197 strains of pathogenic bacteria had been isolated. Among them 125 strains of Gram-positive bacteria accounted for 63.5%, 68 strains of Gram-negative bacteria accounted for 34.5%, 4 strains of fungi accounted for 2.010% of 197 strains of pathogenic bacteria, 54 strains were multidrug resistant bacteria, all of them were Gram-negative bacteria. The highest drug resistance rate of Pseudomonas aeruginosa was 94.4% for cefotaxime, 87.5% for gentamicin for Escherichia coli and 92.9m for ceftaxime in Acinetobacter baumannii. Conclusion\\\;\\\;\\\; The main pathogens of the infection were Gram-positive bacteria. The proportion of multidrug resistant bacteria was high among the pathogenic bacteria, and antibiotics should be selected reasonably according to the results of drug sensitivity test.
【作者单位】：中山大学附属第一医院东院上肢骨科;中山大学附属第一医院东院护理办;中山大学附属第一医院东院骨科;中山大学附属第一医院东院控感科;
【基金】：广东省自然科学基金资助项目(S2013010011916)
【分类号】：R446.5

【参考文献】