骨科Ⅰ类手术患者内植物感染病原菌分布及药敏分析

发布时间：2018-07-31 17:23

【摘要】：目的探讨骨科带内植物的Ⅰ类手术患者感染病原菌分布及药敏结果,为切口感染的诊治提供参考。方法收集2011年1月-2016年10月在医院实施骨科带内植物的2 382例Ⅰ类手术患者临床资料,分析术后发生切口感染患者局部分泌物细菌培养及药敏试验结果。结果 2 382例Ⅰ类手术患者术后发生切口感染65例,感染率2.73%;65例切口感染患者送检标本中54例阳性,阳性率为83.08%,培养出病原菌58株,其中单一病原菌感染50例占92.59%,2种病原菌混合感染4例占7.41%;58株感染病原菌中革兰阳性菌35株占60.34%,革兰阴性菌22株占37.93%,真菌1株占1.72%;检出的革兰阳性菌对青霉素均完全耐药,对万古霉素完全敏感,革兰阴性菌普遍对青霉素、头孢唑林完全耐药,对亚胺培南及万古霉素完全敏感,对其他抗菌药物敏感性高低不一。结论葡萄球菌属及大肠埃希菌是引起骨科带内植物的Ⅰ类切口感染的主要病原菌,检出病原菌普遍对青霉素完全耐药,但对万古霉素、亚胺培南尚完全敏感,对其他抗菌药物敏感性高低不一,应对感染切口尽早采集分泌物进行细菌培养及药敏试验,根据结果合理选择抗菌药物治疗。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and drug sensitivity in patients undergoing Class I surgery with orthopedic plants, and to provide reference for the diagnosis and treatment of incision infection. Methods from January 2011 to October 2016, the clinical data of 2 382 patients undergoing orthopedic intraoperative surgery were collected and the results of bacterial culture and drug sensitivity test in local secretion of patients with incision infection were analyzed. Results 65 cases of incision infection occurred in 2 382 patients with type I operation. The infection rate was 2.73%. The positive rate was 83.08, and 58 strains of pathogenic bacteria were cultured, among the 65 cases of incision infection, the positive rate was 83.08, and the infection rate was 2.73%. Of the 58 pathogens, 35 were Gram-positive bacteria (35 strains), 22 Gram-negative bacteria strains (37.93%), and one fungus strain (1.72%). All the gram-positive bacteria were completely resistant to penicillin. Gram-negative bacteria were generally resistant to penicillin, cefazolin, imipenem and vancomycin, and had different sensitivity to other antibiotics. Conclusion Staphylococcus and Escherichia coli are the main pathogens causing class I incision infection of orthopedic plants. The pathogens are generally resistant to penicillin, but sensitive to vancomycin and imipenem. The sensitivity of other antimicrobial agents is different. Bacterial culture and drug sensitivity test should be carried out as early as possible in the collection of secretions from infected incisions and rational selection of antimicrobial therapy based on the results.
【作者单位】：河南省确山县人民医院骨科;河南省确山县人民医院手术室;河南省确山县人民医院常规室;
【分类号】：R446.5;R687.3

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