下肢开放性骨折后患者医院感染的诱发性因素及病原学特点分析

发布时间：2018-09-19 15:13

【摘要】：目的探讨下肢开放性骨折患者医院感染的诱发性因素,分析其病原菌分布特点,以期临床预防与治疗提供依据。方法选取2011年2月-2016年8月医院接诊的下肢开放性骨折患者537例为研究对象,所有患者创口分泌物实施细菌培养,分析下肢开放性骨折医院感染的诱发性因素,并统计病原菌分布特点。结果 537例患者中发生医院感染26例,感染率为4.84%,单因素和Logistic法显示:受伤至手术时间≥7d、Gustilo分型Ⅲ型、合并糖尿病、外固定、抗菌药物使用剂量不足均为下肢开放性骨折医院感染的独立危险因素(P0.05);26例感染患者共分离病原菌49株,以革兰阳性菌27株占55.10%,革兰阴性菌20株占40.82%,革兰阴性菌中铜绿假单胞菌对头孢唑林耐药率为87.50%,鲍氏不动杆菌对亚胺培南耐药率为100.00%,大肠埃希菌对头孢唑林耐药率为100.00%;革兰阳性菌中金黄色葡萄球菌对利福平耐药率为88.89%,粪肠球菌对亚胺培南与美罗培南耐药率为100.00%,表皮葡萄球菌对阿莫西林与氨苄西林耐药率为100.00%。结论下肢开放性骨折患者医院感染与多种因素有关,感染病原菌以革兰阴性菌为主,临床医师应合理使用抗菌药物,提高疗效。
[Abstract]:Objective to investigate the inducing factors of nosocomial infection in patients with open fracture of lower extremities and analyze the distribution of pathogens in order to provide evidence for clinical prevention and treatment. Methods 537 patients with open fracture of lower extremity were selected from February 2011 to August 2016. The bacteria culture was carried out in the wound secretion of all patients, and the inducing factors of nosocomial infection of open fracture of lower extremity were analyzed. The distribution characteristics of pathogenic bacteria were analyzed. Results among the 537 patients, 26 had nosocomial infection, the infection rate was 4.84.The single factor and Logistic method showed that the time from injury to operation was more than 7 days and Gustilo type 鈪，

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