上肢骨折患者术后伤口感染细菌种类与药敏分析

发布时间：2018-03-30 17:18

本文选题：上肢　切入点：骨折　出处：《中华医院感染学杂志》2017年09期

【摘要】：目的筛查上肢骨折患者术后伤口感染细菌种类分布特点、分析药敏结果,旨在降低耐药菌株产生、控制感染,为临床合理选取抗菌药物提供细菌学参考依据。方法选取2014-2016年372例上肢骨折术后伤口感染患者,比较2014、2015年和2016年伤口细菌种类及分布、主要革兰阳性菌、革兰阴性菌药敏试验结果。结果检出病原菌370株,3年内细菌种类及分布比较,差异无统计学意义;每个年度内,金黄色葡萄球菌百分比高于其他阳性菌株检出率,铜绿假单胞菌百分比高于其他阴性菌株检出率,差异有统计学意义(P0.05);2015、2016年与2014年比较,金黄色葡萄球菌对氨苄西林、氧氟沙星耐药率,表皮葡萄球菌对氨苄西林、莫西沙星耐药率,差异有统计学意义(P0.05);2014年,金黄色葡萄球菌、表皮葡萄球菌对青霉素耐药率高于本年度其他类别抗菌药物,2015、2016年,对青霉素和氨苄西林耐药率高于其他抗菌药物,差异有统计学意义(P0.05);2015年鲍氏不动杆菌对亚胺培南、美罗培南、氧氟沙星耐药率与2014年比较,差异有统计学意义(P0.05);2016年与2015年比较,鲍氏不动杆菌对头孢哌酮/舒巴坦耐药率,差异有统计学意义(P0.05);且各年度内铜绿假单胞菌对氨苄西林耐药率与其他抗菌药物比较,差异有统计学意义(P0.05),鲍氏不动杆菌对头孢曲松、头孢他啶、头孢吡肟、庆大霉素、阿米卡星和环丙沙星耐药率,差异有统计学意义(P0.05)。结论加强上肢骨折患者术后伤口感染观察、及时筛查创面病菌种类分布信息,根据药敏结果选取合理抗菌药物,有助于控制感染、促进伤口愈合。
[Abstract]:Objective to screen the distribution of bacteria of wound infection in patients with upper limb fracture after operation and analyze the results of drug sensitivity in order to reduce the production of drug-resistant strains and control infection, and to provide the bacteriological reference for the rational selection of antimicrobial agents in clinic.Methods 372 patients with wound infection after upper limb fracture from 2014 to 2016 were selected to compare the types and distribution of wound bacteria in 2014, 2015 and 2016, and the results of drug sensitivity test of major Gram-positive bacteria and Gram-negative bacteria.Results 370 strains of pathogenic bacteria were detected. There was no significant difference in the species and distribution of bacteria within 3 years, and the percentage of Staphylococcus aureus was higher than that of other positive strains in each year.The resistance rate of moxifloxacin was statistically significant (P 0.05). In 2014, the resistance of Staphylococcus aureus and Staphylococcus epidermidis to penicillin was higher than that of other antimicrobial agents of this year. In 2016, the resistance rate to penicillin and ampicillin was higher than that of other antibiotics.The difference was statistically significant (P 0.05); the resistance rate of Acinetobacter baumannii to imipenem, meropenem and ofloxacin in 2015 was significantly higher than that in 2014, and the resistance rate of Acinetobacter baumannii to cefoperazone / sulbactam was significantly higher in 2016 than in 2015.There were significant differences in the resistance of Pseudomonas aeruginosa to ampicillin in each year compared with other antimicrobial agents (P 0.05), Acinetobacter baumannii to ceftriaxone, ceftazidime, cefepime, gentamicin.The drug resistance rate of amikacin and ciprofloxacin was significantly higher than that of ciprofloxacin.Conclusion it is helpful to control infection and promote wound healing by strengthening observation of wound infection in patients with upper limb fracture, screening distribution information of bacteria in time, and selecting reasonable antibiotics according to drug sensitivity results.
【作者单位】：河南省洛阳正骨医院河南省骨科医院膝部损伤二科上肢损伤二科;河南省洛阳正骨医院河南省骨科医院脊柱外科;河南省洛阳正骨医院河南省骨科医院髋部损伤四科;河南省洛阳正骨医院河南省骨科医院ICU;
【分类号】：R687.3

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