骨科无菌手术中不同抗菌药物对切口感染致病菌的耐药性分析

发布时间：2018-11-02 14:59

【摘要】：目的:分析骨科无菌手术中不同抗菌药物(青霉素、环丙沙星、阿米卡星、氨苄西林、红霉素、妥布霉素、庆大霉素、头孢唑啉、诺氟沙星和万古霉素)对切口感染致病菌的耐药情况。方法:选取2014年8月—2016年11月间收治的骨科无菌手术患者104例,将其分成A组和B组,每组52例;A组患者于麻醉诱导期、术中和术后第3天给予抗菌药物预防感染,B组患者于术后到切口拆线时间内给予抗菌药物预防感染;比较两组患者预防感染用药后切口感染的发生率,以及致病菌的药敏试验结果。结果:A组患者用药后切口感染的发生率为3.85%低于B组为19.23%(P0.05),未发生混合感染,而B组患者混合感染的发生率为7.69%(P0.05);A组患者共培养出2株革兰阳性球菌,B组共培养出5株革兰阳性球菌和2株革兰阴性杆菌;分离出的致病菌对多种抗菌药物有耐药性。结论:骨科无菌手术患者在麻醉诱导期、术中和术后第3天采用抗菌药物预防感染,优于术后给药,但需注意的是不可任意延长抗菌药物的用药时间,以免提高感染的发生率和耐药性。
[Abstract]:Objective: to analyze different antimicrobial agents (penicillin, ciprofloxacin, amikacin, ampicillin, erythromycin, tobramycin, gentamicin, cefazolin) in aseptic orthopedic surgery. Norfloxacin and vancomycin) resistance to wound infection pathogens. Methods: 104 patients undergoing orthopedic aseptic surgery from August 2014 to November 2016 were divided into two groups: group A (52 cases) and group B (52 cases). The patients in group A were given antibiotics to prevent infection during anesthesia induction period, intraoperative and postoperative 3 days, and patients in group B were given antibiotics to prevent infection within the time from postoperative to incision. The incidence of incision infection and the results of antibiotic sensitivity test were compared between the two groups. Results: the incidence of incision infection in group A was lower than that in group B (3.85% vs 19.23%, P0.05), but the incidence of mixed infection in group B was 7.69% (P0.05). Two strains of gram-positive cocci were cultured in group A, five strains of gram-positive cocci and two strains of gram-negative bacilli were cultured in group B. the isolated pathogenic bacteria were resistant to many antimicrobial agents. Conclusion: during anesthesia induction period, during operation and 3 days after operation, the patients undergoing orthopedic aseptic surgery should use antibiotics to prevent infection, which is superior to postoperative administration, but it should not be arbitrarily prolonged. Avoid increasing the incidence of infection and drug resistance.
【作者单位】：奉新县中医院骨科;
【分类号】：R446.5;R687

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