创伤性骨折感染创面分泌物病原菌分布调查及相关耐药性分析

doi:10.3969/j.issn.1006-5253.2019.05.012

摘要
图/表
参考文献
相关文章 (13)

全文: PDF (904 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的研究创伤性骨折感染创面分泌物病原菌的分布情况及相关耐药性，以期为临床合理应用抗菌药物提供指导。方法将2017年7月至2018年10月期间于某院接受诊治的3 154例创伤性骨折并发创面感染患者作为观察对象，对患者的一般资料进行收集，并对感染创面分泌物内病原菌分布、耐药性进行分析。结果 3 154例创伤性骨折感染创面分泌物中共分离出病原菌3 154株。其中革兰阳性菌共检出2 129株（67.5%），主要为金黄色葡萄球菌、表皮葡萄球菌；革兰阴性菌共检出984株（31.2%），主要为大肠埃希菌、阴沟肠杆菌。金黄色葡萄球菌、表皮葡萄球菌对利奈唑胺、氨苄西林、替加环素及呋喃妥因存在高度敏感性，耐药率均为0.0%，且表皮葡萄球菌对环丙沙星存在高度敏感性，耐药率是0.0%，但金黄色葡萄球菌、表皮葡萄球菌对青霉素耐药率均为100%，同时金黄色葡萄球菌、表皮葡萄球菌对其他抗菌药物的耐药率均＜50%。大肠埃希菌对头孢唑啉、氨苄西林、舒巴坦、头孢曲松、超广谱β内酰胺酶、左氧氟沙星的耐药性均＞70%，但对红霉素及亚胺硫霉素、哌拉西林、丁胺卡那霉素、厄他培南无耐药性，而阴沟肠杆菌对亚胺硫霉素无耐药性，但对其他15种抗菌药物的耐药率均＞20%。结论创伤性骨折感染创面分泌物病原菌分布以金黄色葡萄球菌、表皮葡萄球菌等革兰阳性菌为主，临床治疗需根据耐药性分析结果合理选择抗菌药物，避免感染暴发流行。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	王红霞
	王晓怀
	邱燕芬

关键词 ：创伤性骨折, 感染创面, 分泌物病原菌, 耐药性, 抗菌药物

Abstract：

Objective To study the distribution of pathogenic bacteria in wounds of traumatic fractures and related drug resistance, in order to provide guidance for the rational application of antibacterial drugs.Methods Totally 3 154 patients with traumatic fracture complicated with wound infection treated in our hospital from July 2017 to October 2018 were observed in this study.The general data of the patients were collected, and the distribution and drug resistance of pathogenic bacteria in the wounds of infected wounds were analyzed.Results A total of 3 154 pathogenic bacteria were isolated from infected wounds in 3154cases with traumatic fractures.Among them, 2 129 cases of strains (67.5%) were detected gram-positive bacteria, mainly staphylococcus aureus and staphylococcus epidermidis, and 984 cases of strains (31.2%) were detected gramnegative bacteria, mainly Escherichia coli and Enterobacter cloacae. The Staphylococcus aureus and Staphylococcus epidermidis were highly sensitive to linezolid, ampicillin, tigecycline and nitrofurantoin, and the drug resistance rate was 0.0%. And Staphylococcus epidermidis was highly sensitive to ciprofloxacin, and the drug resistance rate was 0.0%. However, the resistance rate of Staphylococcus aureus and Staphylococcus epidermidis to penicillin was 100%. At the same time, the resistance rates of Staphylococcus aureus and Staphylococcus epidermidis to other antibiotics were under 50%. Escherichia coli resistance to cefazolin, ampicillin, sulbactam, ceftriaxone, extendedspectrum β-lactamase, levofloxacin was over 70%, but for erythromycin and imipenem, Piperacillin, amikacin, ertapenem it was non-resistant. Enterobacter cloacae was not resistant to imipenem, but the resistance rate to other 15 antibacterial drugs was over 20%.Conclusion The distribution of pathogenic bacteria in wounds of traumatic fractures is mainly gram-positive bacteria such as Staphylococcus aureus and Staphylococcus epidermidis. The clinical treatment needs to select antibiotics according to the results of drug resistance analysis to avoid the outbreak of infection.

Key words： traumatic fracture infected wound secretory pathogen drug resistance antibiotics

收稿日期: 2019-02-27

通讯作者: 王红霞，Email：wanghongxia0983@163.com

引用本文:

王红霞,王晓怀,邱燕芬. 创伤性骨折感染创面分泌物病原菌分布调查及相关耐药性分析[J]. 中国医院统计, 2019, 26(5): 359-362.
Wang Hongxia, Wang Xiaohuai,Qiu Yanfen. Investigation on distribution of pathogenic bacteria in wounds of traumatic fracture infection and analysis of related drug resistance. journal1, 2019, 26(5): 359-362.

链接本文:

http://manu58.magtech.com.cn/Jwk_zgyytj/CN/10.3969/j.issn.1006-5253.2019.05.012 或 http://manu58.magtech.com.cn/Jwk_zgyytj/CN/Y2019/V26/I5/359

［1］谢承成，陈南，吴迪．开放性骨折术后创面感染的病原菌及耐药性分析［J］．实用骨科杂志，2018，24(8)：682-686．
［2］刘立柱，宋世锋，张伟，等．开放性骨折患者创面感染的病原菌分布与药敏分析［J］．中华医院感染学杂志，2016，26(15)：3505-3507．
［3］林德涛，赵宇，代风波，等．创伤性胫腓骨骨折患者创口感染病原菌分布与耐药性特点及相关预防措施研究［J］．中华医院感染学杂志，2018，28(13)：2009-2011，2019.
［4］HAFFAJEE AD， TORRESYAP G，SOCRANSKY SS． Clinical changes following four different periodontal therapies for the treatment of chronic periodontitis：1year results［J］． J Clin Periodontol， 2007， 34(3)：243-253．
［5］万峰格，邹吉锋，曹海云，等．上肢骨折患者术后伤口感染细菌种类与药敏分析［J］．中华医院感染学杂志，2017，27(9)：2068-2071．
［6］李飞，庞彬.开放性胫骨骨折内固定术后感染的危险因素和病原菌分析［J］.解放军医药杂志，2018，30（11）：55-57.
［7］裘情密，沈健健，施绒舟，等．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［J］．中华医院感染学杂志，2017，27(6)：1325-1328．
［8］金国华，赵胜春，陈欣，等．开放性骨折患者术后伤口感染的细菌学特点及对抗菌药物的耐药性分析［J］．中华医院感染学杂志，2017，27(6)：1321-1324．
［9］WENNSTROM JL TOMASI C，BERTELLE A，et al．Fullmouth ultrasonic debridement versus quadrant scaling and root planing as an initial approach in the treatment of chronic periodontitis［J］．J Clin Periodontol，2005，32(8)：851-859．
［10］汪颖，王迪芬，刘颖，等.重症感染患者的感染部位及病原微生物种类与血清降钙素及D二聚体水平的关系［J］.贵州医科大学学报，2017，42（10）：1164-1167.
［11］张兴翔，金敏.重症监护病房中心静脉导管相关性血流感染的病原菌分布及耐药性［J］. 中国微生态学杂志，2016，28（1）：76-78.［12］陆一平，陈艳华，江宗蔚，等．肿瘤患者医院感染病原菌分布及耐药性分析［J］．医学检验与临床，2018(4)：28-31．
［13］KOMATSU A，IKEDA A，KIKUCHI A， et al．Osteoporosisrelated fractures in HIVinfected patients receiving longterm tenofovir disoproxil fumarate：An observational cohort study［J］．Drug Saf，2018，41(9)：843-848．
［14］李玉洁，贺逸红，刘海兰．血清降钙素原预示革兰阴性细菌致骨折术后感染的价值评估［J］．河北医药，2017，39(7)：1059-1060,1063．
［15］徐海燕，刘姗，冯沙娜，等．实体瘤患者发生血流感染的病原学特点及预后分析［J］．中华医院感染学杂志，2018，28(8)：1158-1161.
［16］高敏．抗生素治疗开放性骨折伤口合并多重耐药菌感染防治措施［J］．北方药学，2017，14(8)：186-187．
［17］EICHENBERGER EM，THADEN JT，SHARMAKUINKEL B，et al．Polymorphisms in fibronectin binding proteins A and B among Staphylococcus aureus bloodstream isolates are not associated with arthroplasty infection［J］．PLOS One，2015，10(11)：e0141436．
［18］雷利强，王登峰．四肢骨折内固定术后切口感染患者中病原菌的分布特点及药敏试验［J］．临床医学研究与实践，2018(19)：98-99．