创伤部位对四肢骨折术后感染患者病原菌及耐药性的影响

发布时间：2018-04-18 00:38

本文选题：创伤部位 + 四肢骨折　；参考：《中华医院感染学杂志》2017年06期

【摘要】：目的探讨创伤部位对四肢骨折术后感染患者病原菌及耐药性的影响。方法回顾性分析2013年1月-2016年7月在医院创伤外科治疗的四肢骨折术后感染患者82例,统计总感染率,分析骨折患者病原菌的分布及耐药性。结果回顾性分析5917例四肢骨折患者,其中发生感染的患者82例,感染率为1.39%,82例患者共分离出病原菌97株,其中,单一感染67例占81.7%,混合感染15例占18.3%,病原菌以革兰阳性菌为主63株,革兰阴性菌27株,真菌7株;胫腓骨骨折患者37例,分离出病原菌43株,其中单一感染患者31例占72.1%,混合感染患者6例占27.9%;股骨骨折患者24例,分离出病原菌29株,其中单一感染患者19例占79.2%,混合感染患者5例占20.8%,感染菌以革兰阳性菌为主21株;尺桡骨骨折患者21例,分离出病原菌25株,其中单一感染患者17例占81.0%,混合感染患者4例占19.0%,感染菌以革兰阳性菌为主18株,革兰阴性菌6株;金黄色葡萄球菌对苄卡西林和万古霉素很敏感,表皮葡萄球菌对万古霉素很敏感,鸟粪球菌对万古霉素很敏感;大肠埃希菌对亚胺培南和美罗培南很敏感,阴沟肠杆菌对亚胺培南和美罗培南很敏感,铜绿假单胞菌对亚胺培南和美罗培南很敏感,鲍氏不动杆菌对庆大霉素和头孢吡肟不敏感,对亚胺培南和美罗培南很敏感。结论四肢骨折患者术后感染仍以金黄色葡萄球菌和表皮葡萄球菌为主,对于不同创伤部位的感染患者一定要给予对症治疗,合理使用抗菌药物,降低四肢骨折患者的感染率。
[Abstract]:Objective to investigate the effect of trauma site on pathogenic bacteria and drug resistance in patients with postoperative infection of extremities fracture.Methods from January 2013 to July 2016, 82 patients with postoperative infection of limbs fractures treated in hospital trauma surgery were retrospectively analyzed. The total infection rate was counted, and the distribution and drug resistance of pathogenic bacteria in patients with fracture were analyzed.Results A retrospective analysis was made on 5917 patients with limb fractures, of whom 82 were infected, and the infection rate was 1.39%. 97 strains of pathogenic bacteria were isolated from 82 patients.There were 67 cases of single infection, 15 cases of mixed infection, 63 strains of Gram-positive bacteria, 27 strains of Gram-negative bacteria, 7 strains of fungi, and 37 cases of tibia and fibula fracture.Among them, 31 cases were single infection, 6 cases were mixed infection, 24 cases were fracture of femur, 29 strains were isolated, 19 cases were single infection, 5 cases were mixed infection, 21 strains were Gram-positive bacteria.Twenty-five strains of pathogenic bacteria were isolated from 21 patients with ulnar and radial fractures. Among them, 17 cases were single infection patients (81.0%), 4 cases were mixed infection patients (19.0%), 18 strains were Gram-positive bacteria and 6 strains were Gram-negative bacteria.Staphylococcus aureus is sensitive to benzyl kassim and vancomycin, Staphylococcus epidermidis is sensitive to vancomycin, ornithococcus is sensitive to vancomycin, Escherichia coli is sensitive to imipenem and meropenem,Enterobacter cloacae was sensitive to imipenem and meropenem, Pseudomonas aeruginosa was sensitive to imipenem and meropenem, Acinetobacter baumannii was insensitive to gentamicin and cefepime, and sensitive to imipenem and meropenem.Conclusion Staphylococcus aureus and Staphylococcus epidermidis are the main infections in patients with extremities fracture after operation.
【作者单位】：浙江省永康市中医院骨伤科;
【分类号】：R687.3

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