摘要
目的探讨骨折复位内固定术后切口感染病原菌分布及耐药性,为临床抗菌药物的合理使用提供依据。方法对2006年1月-2012年3月行骨折复位内固定术后,切口感染的68例患者临床资料进行回顾性分析。结果深部感染16例,浅部感染52例,分别占23.53%,76.47%;共培养出病原菌73株,其中革兰阳性球菌24株占32.88%,革兰阴性杆菌49株占67.12%;常见感染病原菌对10种常用抗菌药物耐药率≥50.00%,金黄色葡萄球菌、肠球菌属及表皮葡萄球菌对青霉素G、氨苄西林、苯唑西林、磺胺甲噁唑/甲氧苄啶耐药性均较高>75.00%,鲍氏不动杆菌对多数抗菌药物100.00%耐药,肺炎克雷伯菌对头孢唑林、头孢曲松、哌拉西林、氨曲南耐药率>50.00,铜绿假单胞菌对头孢唑林、米诺环素耐药率达100.00%,阴沟肠杆菌对头孢唑林、头孢噻肟、头孢曲松、哌拉西林、米诺环素的耐药率>80.00%,大肠埃希菌除对亚胺培南敏感为100.00%外,对其他9种抗菌药物已经完全耐药。结论骨折内固定术后患者切口感染病原菌较为复杂,对临床常用药物耐药性普遍高,应依据药敏试验结果合理选择抗菌药物控制耐药菌的进一步发生。
OBJECTIVE To explore the distribution and drug resistance of the pathogenic bacteria causing incision infections after the fracture reduction and internal fixation so as to provide basis for reasonable use of antibiotics.METHODS The clinical data of 68 patients with incision infections who underwent the fracture reduction and internal fixation from Jan 2006 to Mar 2012 were analyzed retrospectively.RESULTS There were 16（23.53%） patients with deep infections and 52（76.47%）patients with superficial infections.A total of 73 strains of pathogens were isolated,including 24（32.88%）strains of gram-positive cocci and 49（67012%）strains of gram-negative bacilli.The drug resistance rates of the common pathogens to 10 commonly used antibiotics were higher than 50.00%,the drug resistance rates of Staphylococcus aureus,Enterococci,and S.epidermidis were higher than 75.00% to penicillin G,ampicillin,oxacillin,and sulfamethoxazole/trimethoprim,the drug resistance rate of Acinetobacter baumannii to most of antibiotics was 100.00%,the drug resistance rates of Klebsiella pneumoniae to cefazolin,ceftriaxone,piperacillin,and aztreonam were higher than 50.00%,the drug resistance rates of Pseudomonas aeruginosa to cefazolon and minocycline reached up to 100.00%,the drug resistance rates of Enterobacter cloacae to cefazolin,cefotaxime,ceftriaxone,piperacillin,and minocycline were higher than 80.00%.Except for the 100.0% sensitivity rate to imipenem,Escherichia coli was completely resistant to other nine antibiotics.CONCLUSION The species of pathogens causing incision infections in the patients undergoing fracture reduction and internal fixation are complex,which are highly resistant to commonly used antibiotics.It is necessary to select antibiotics reasonably on the basis of drug susceptibility testing to prevent the prevalence of the drug resistant bacteria.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第24期5656-5658,共3页
Chinese Journal of Nosocomiology
关键词
骨折
内固定
切口感染
耐药率
Fracture
Internal fixation
Incision infection
Drug resistance rate
