手外伤感染患者伤口病原菌分布及耐药性分析(1)
[摘要] 目的 通過分析本院2014～2016年手外伤患者伤口感染1358株病原菌分布及对抗菌素药物敏感性，为临床医师了解手外伤感染患者病原菌分布特点及合理使用抗菌药物提供科学依据。 方法 对细菌培养阳性并经鉴定细菌采用K-B纸片扩散法和最低抑菌浓度琼脂稀释法对其进行药物敏感性试验。 结果 2425例患者共分离出46种1358株细菌，前十位细菌占71.94%。革兰阴性菌占63.0%。革兰阴性杆菌前几位为铜绿假单胞菌、大肠埃希菌、肺炎克雷伯杆菌。革兰阳性菌占29.0%，革兰阳性菌前几位为金黄色葡萄球菌、表皮葡萄球菌、人葡萄球菌。厌氧菌和真菌分别占3.09%、2.72%。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为26.62%和25.90%；肠杆菌科细菌对2种碳青霉烯类的耐药率仍然较低，在10%以下。肺炎克雷伯菌对美罗培南及亚胺培南的耐药率分别为14.4%、16.3%。未发现对万古霉素、替考拉宁和利奈唑胺耐药的金黄色葡萄球菌及凝固酶阴性葡萄球菌。 结论手外伤感染患者伤口分泌物未检出耐万古霉素、利奈唑胺和替考拉宁的金黄色葡萄球菌及凝固酶阴性葡萄球菌株。革兰阴性杆菌呈多重耐药性，均有检出耐碳青霉烯类抗菌素的菌株并日趋增加，应当采取有效措施遏制此类细菌在医院的传播扩散。
[关键词] 感染；病原菌分布；耐药性；手外伤
[中图分类号] R658.2 [文献标识码] B [文章编号] 1673-9701(2018)04-0111-05
[Abstract] Objective To analyze the distribution of 1358 strains of pathogenic bacteria in the wound infection in the patients with hand traumatic infections in our hospital from 2014 to 2016 and the sensitivity to antibiotics， so as to provide a scientific basis for clinicians to understand the distribution characteristics of pathogenic bacteria in the patients with hand traumatic infection and the rational use of antibacterial agents. Methods The drug susceptibility test was carried out on the bacteria which were positive by bacterial culture and identified by K-B disk diffusion method and the minimum inhibitory concentration agar dilution method. Results A total of 46 types of 1358 bacteria were isolated from 2425 patients. The top ten bacteria accounted for 71.94%. Gram-negative bacteria accounted for 63.0%. The top-ranking Gram-negative bacilli were Pseudomonas aeruginosa， Escherichia coli， and Klebsiella pneumoniae. Gram-positive bacteria accounted for 29.0%. The top-ranking Gram-positive bacteria were Staphylococcus aureus， Staphylococcus epidermidis， and Staphylococcus aureus. Anaerobic bacteria and fungi accounted for 3.09% and 2.72% respectively. The drug resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 26.62% and 25.9% respectively； the resistance rate of Enterobacteriaceae to the two types of carbapenems remained still low， below 10%. The resistance rate of Klebsiella pneumoniae to meropenem and imipenem was 14.4% and 16.3% respectively. No S. aureus and coagulase negative staphylococci were found to be resistant to vancomycin， teicoplanin and linezolid. Conclusion Staphylococcus aureus and coagulase-negative Staphylococcus aureus strains are not detected to be resistant to vancomycin， linezolid and teicoplanin in the wound secretions of patients with hand traumatic infection. Gram-negative bacilli are multi-drug resistant strains， and strains resistant to carbapenem antibiotics are always detected， which are in an increasing trend. Effective measures should be taken to curb the spread of such bacteria in hospitals., 百拇医药(孙景熙 王福斌 陈剑明)
[关键词] 感染；病原菌分布；耐药性；手外伤
[中图分类号] R658.2 [文献标识码] B [文章编号] 1673-9701(2018)04-0111-05
[Abstract] Objective To analyze the distribution of 1358 strains of pathogenic bacteria in the wound infection in the patients with hand traumatic infections in our hospital from 2014 to 2016 and the sensitivity to antibiotics， so as to provide a scientific basis for clinicians to understand the distribution characteristics of pathogenic bacteria in the patients with hand traumatic infection and the rational use of antibacterial agents. Methods The drug susceptibility test was carried out on the bacteria which were positive by bacterial culture and identified by K-B disk diffusion method and the minimum inhibitory concentration agar dilution method. Results A total of 46 types of 1358 bacteria were isolated from 2425 patients. The top ten bacteria accounted for 71.94%. Gram-negative bacteria accounted for 63.0%. The top-ranking Gram-negative bacilli were Pseudomonas aeruginosa， Escherichia coli， and Klebsiella pneumoniae. Gram-positive bacteria accounted for 29.0%. The top-ranking Gram-positive bacteria were Staphylococcus aureus， Staphylococcus epidermidis， and Staphylococcus aureus. Anaerobic bacteria and fungi accounted for 3.09% and 2.72% respectively. The drug resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 26.62% and 25.9% respectively； the resistance rate of Enterobacteriaceae to the two types of carbapenems remained still low， below 10%. The resistance rate of Klebsiella pneumoniae to meropenem and imipenem was 14.4% and 16.3% respectively. No S. aureus and coagulase negative staphylococci were found to be resistant to vancomycin， teicoplanin and linezolid. Conclusion Staphylococcus aureus and coagulase-negative Staphylococcus aureus strains are not detected to be resistant to vancomycin， linezolid and teicoplanin in the wound secretions of patients with hand traumatic infection. Gram-negative bacilli are multi-drug resistant strains， and strains resistant to carbapenem antibiotics are always detected， which are in an increasing trend. Effective measures should be taken to curb the spread of such bacteria in hospitals., 百拇医药(孙景熙 王福斌 陈剑明)