摘要
目的分析慢性化脓性骨髓炎患者窦道及病灶组织感染的常见病原菌分布及耐药情况,为临床合理应用抗菌药物,控制医院感染提供科学依据。方法回顾性调查2008年1月—2013年12月间慢性化脓性骨髓炎患者窦道及病灶组织感染的现状,统计分析208株病原菌的药敏试验结果。结果共分离出208株病原菌,其中革兰阳性球菌122株,占58.7%,革兰阴性杆菌78株,占37.5%,真菌8株,占3.8%;革兰阳性球菌中主要为金黄色葡萄球菌及溶血性链球菌,革兰阴性杆菌中包括假单胞菌属及克雷伯菌属等;药敏试验结果显示大多数细菌具有较高的耐药性,金黄色葡萄球菌对万古霉素最敏感,对克林霉素的耐药率为15.2%,而对青霉素、头孢西丁、头孢哌酮、左氧氟沙星及头孢唑林的耐药率均大于70.0%;假单胞菌属对头孢哌酮、阿米卡星及庆大霉素的耐药率较低,分别为13.9%、22.2%及27.8%,而对亚胺培南、阿莫西林及头孢他啶的耐药率均大于80.0%;克雷伯菌属对头孢哌酮、妥布霉素及阿米卡星的耐药率较低,分别为10.0%、15.0%和20.0%,而对其他抗菌药物的耐药率均大于60.0%。结论抗菌药物的广泛应用,使条件致病菌成为慢性骨髓炎患者窦道及病灶组织分离的重要病原菌,临床上应严格按照细菌学检查结果,合理应用抗菌药物,加强抗菌药物的监管,积极预防和控制感染。
Objective To analyse the clinical distribution and drug resistance of pathogens causing infections in patients of chronic suppurative osteomyelitis, to provide the scientific evidence for clinical controlling of them. Methods The clinical status of pathogens causing infections in patients of chronic suppurative osteomyelitis from Jan. 2008 to Dec. 2013 was investigated retrospectively. The susceptibility testing results of 208 cases were analyzed statistically. Results Of 208 strains of pathogens isolated, including 122 （58.7%） stains of gram - positive bacilli, 78 （37.5%） stains of gramnegative bacilli and 8 （3.8%） stains of fungus; Staphylococcus aureus and Hemolytic streptococcus were the most common gram - positive bacteria, Pseudomonas and Klebsiella were the most common gram - negative bacteria ; the drug susceptibility testing demonstrated that the drug resistance of most of the pathogens was high, Staphylococcus aureus was the most sensitive to vancomycin, the resistance rate to elindamyein was 15.2% ,the resistance rate to penicillin, cefoxitin, cefoperazone, levofloxacin and cefazolin were all above 70. 0%. the drug - resistance rates of Pseudomonas to cefoperazone, amikaein and gentamiein were low, accounting for 13.9% ,22. 2% and 27. 8% , the resistance rate to imipenem , amoxicillin and ceftazidime were all above 80. 0%. the drug- resistance rates of Klebsiella to cefoperazone, tobramycin and amikacin were low, accounting for 10. 0%, 15.0% and 20. 0%, the resistance rate to other antimicrobial agents were all above 60. 0%. Condusions The opportunistic pathogens are the major pathogens isolated from chronic suppurative osteomyelitis, due to extensive use of antibiotics,The clinical doctor should prescribe the antibiotics reasonably according to etiology, to strengthen the regulation of antimicrobial drugs, active prevention and control of infection.
出处
《医药论坛杂志》
2015年第6期36-38,42,共4页
Journal of Medical Forum
关键词
骨髓炎
病原菌
抗菌药物
细菌分布
耐药性
Osteomyelitis
Pathogen
Antimicrobial agent
Bacterial distribution
Drug resistance
