开放性骨折患者创口感染的病原菌分布及抗感染治疗分析

发布时间：2018-06-16 04:34

本文选题：开放性骨折 + 病原菌　；参考：《中华医院感染学杂志》2017年06期

【摘要】：目的探究开放性骨折患者创口感染后的病原菌分布以及对患者进行抗感染治疗的情况,为开放性骨折患者的相关治疗提供可以借鉴的临床依据。方法选择医院2012年3月-2016年3月收治的开放性骨折患者70例,采集患者创口标本进行病原菌的培养、分离,对病原菌的分布进行统计,并进行耐药试验。结果 70例患者送检的标本共分离出病原菌75株,其中革兰阳性菌27株占36.0%,以金黄色葡萄球菌13株为主占17.3%,革兰阴性菌48株占64.0%,以阴沟肠杆菌19株为主占25.3%,检测显示分离出的革兰阳性菌中,金黄色葡萄球菌对利福平的敏感率最高为100.0%,对氨苄西林的敏感率最低为38.4%,粪肠球菌对氨苄西林的敏感率最高为100.0%,对头孢曲松的敏感率最低为0,表皮葡萄球菌对环丙沙星的敏感率最高为50.0%,对头孢曲松的敏感率最低为10.0%,分离出的革兰阴性菌中,鲍氏不动杆菌对美罗培南的敏感率最高为100.0%,对头孢曲松的敏感率最低为50.0%,铜绿假单胞菌对哌拉西林的敏感率最高为87.5%,对头孢曲松的敏感率最低为37.5%,大肠埃希菌对美罗培南的敏感率最高为100.0%,对头孢曲松以及哌拉西林的敏感率最低均为50.0%,阴沟肠杆菌对美罗培南的敏感率最高为100.0%,对洛美沙星以及哌拉西林的敏感率最低均为68.4%。结论造成开放性骨折患者创口感染的病原菌以革兰阴性菌为主,并且常规药物对于病原菌的抑制效果较低,因此在对患者治疗的过程中根据患者感染情况对症用药,以取得良好的治疗效果。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria after wound infection in patients with open fracture and to provide reference for the treatment of open fracture. Methods from March 2012 to March 2016, 70 patients with open fracture were selected. The wound specimens were collected for pathogen culture, isolation, distribution statistics and drug resistance test. Results 75 strains of pathogenic bacteria were isolated from 70 patients. Among them, 27 strains of Gram-positive bacteria accounted for 36.0%, 13 strains of Staphylococcus aureus accounted for 17.3%, 48 strains of Gram-negative bacteria accounted for 64.0 strains, 19 strains of Enterobacter cloacae accounted for 25.3%. Staphylococcus aureus has the highest sensitivity to rifampicin, the lowest to ampicillin is 38.4. Enterococcus faecalis has the highest sensitivity to ampicillin, the lowest to ceftriaxone, and Staphylococcus epidermidis to ring. The highest sensitivity rate of Profloxacin was 50.0 and the lowest sensitivity to ceftriaxone was 10.0%. Acinetobacter baumannii has the highest sensitivity to meropenem, the lowest to ceftriaxone, 87.5 to piperacillin, 37.5 to ceftriaxone, and 50.0 to ceftriaxone. The highest sensitivity rate of meropenem was 100.0g, the lowest sensitivity to ceftriaxone and piperacillin was 50.0, the highest sensitivity of Enterobacter cloacae to meropenem was 100.0. the lowest sensitivity to lomefloxacin and piperacillin was 68.4. Conclusion Gram-negative bacteria are the main pathogens causing wound infection in patients with open fracture, and the inhibitory effect of routine drugs on pathogens is low. In order to obtain good therapeutic effect.
【作者单位】：慈溪市人民医院骨科;
【基金】：浙江省自然科学基金资助项目(S201102002426)
【分类号】：R683

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