骨科伤口标本分离革兰阴性杆菌及其耐药性

发布时间：2018-05-03 07:03

本文选题：骨科 + 伤口　；参考：《中国感染控制杂志》2016年02期

【摘要】：目的了解骨科伤口标本分离革兰阴性(G-)杆菌的分布及其耐药性,为临床合理使用抗菌药物提供依据。方法收集2011年1月—2013年12月某综合性医院骨科各病区分离的682株G-杆菌,进行药敏结果分析。结果骨科伤口标本的G-杆菌主要是铜绿假单胞菌(16.72%)、大肠埃希菌(15.40%)和阴沟肠杆菌(12.76%)。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌检出率分别为54.29%(57/105)和31.43%(22/70),两种细菌均主要分布在创伤骨科,分别占49.12%和45.45%。大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌对美罗培南和亚胺培南的敏感率均为100%。大肠埃希菌和肺炎克雷伯菌对阿米卡星、哌拉西林/他唑巴坦、阿莫西林/克拉维酸的敏感率均80%。除对哌拉西林的敏感率为64.37%外,阴沟肠杆菌对大部分抗菌药物敏感率介于71.26%~100.00%。铜绿假单胞菌除对头孢吡肟和氨曲南的敏感率为78.95%和65.79%外,对其他抗菌药物的敏感率均85%。结论 G-杆菌是骨科伤口感染的重要病原菌,了解其菌种分布及耐药性,有利于合理使用抗菌药物,提高临床治疗效果。
[Abstract]:Objective to investigate the distribution and drug resistance of Gram-negative G-bacillus isolated from orthopedic wound specimens, and to provide evidence for rational use of antimicrobial agents in clinic. Methods from January 2011 to December 2013, 682 strains of G- bacilli isolated from orthopedic departments of a general hospital were collected and the drug sensitivity results were analyzed. Results the G- bacteria of orthopedics wounds were mainly Pseudomonas aeruginosa 16.722a, Escherichia coli 15.40) and Enterobacter cloacae 12.7662. The detection rates of Escherichia coli and Klebsiella pneumoniae were 54.29 and 31.4322 / 70, respectively. The two bacteria were mainly distributed in traumatic orthopedics (49.12%) and Klebsiella pneumoniae (45.45%). Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae were all sensitive to meropenem and imipenem. The susceptibility rates of Escherichia coli and Klebsiella pneumoniae to amikacin, piperacillin / tazobactam, amoxicillin / clavulanic acid were 80%. Except for piperacillin (64.37%), Enterobacter cloacae was sensitive to most antibiotics between 71.26 and 100.00000. Except for cefepime and aztreonam, Pseudomonas aeruginosa had a sensitivity rate of 78.95% and 65.79% to other antimicrobial agents. Conclusion G- bacillus is an important pathogen of orthopedic wound infection. Understanding the distribution and drug resistance of G- bacillus is beneficial to the rational use of antimicrobial agents and the improvement of clinical therapeutic effect.
【作者单位】：北京积水潭医院;
【基金】：吴阶平医学基金会临床科研专项资助(320.6750.10078)
【分类号】：R446.5

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