| 张晓娟,郭小彬,杨宏昕.骨伤科分泌物病原菌耐药性分析及抗感染药物选择[J].安徽医药,2022,26(11):2275-2279. |
| 骨伤科分泌物病原菌耐药性分析及抗感染药物选择 |
| Analysis of drug resistance of pathogenic bacteria in orthopedic and traumatic secretion and selection of anti-infective drugs |
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| DOI：10.3969/j.issn.1009-6469.2022.11.035 |
| 中文关键词: 外科伤口感染 骨科 伤口分泌物 耐药性 |
| 英文关键词: Surgical wound infection Orthopedics Wound secretions Drug resistance |
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| 中文摘要: |
| 目的分析骨伤科伤口分泌物病原菌分布及耐药性，为临床合理使用抗菌药物提供依据。方法收集 2017年 1月至 2020年 12月内蒙古自治区人民医院骨伤科分离的 586株阳性菌株，采用 VITEK 2 Comapct 60全自动细菌鉴定药敏分析系统对细菌鉴定和药敏进行分析。结果分离出阳性菌株 586株，革兰阳性菌 408株，占 69.62%；革兰阴性菌 171株，占 29.18%。革兰阳性球菌检出前三位分别是:金黄色葡萄球菌，表皮葡萄球菌，粪肠球菌。革兰阴性杆菌检出前三位分别是:大肠埃希菌，阴沟肠杆菌，肺炎克雷伯菌。药敏试验结果表明革兰阳性球菌中金黄色葡萄球菌和表皮葡萄球菌对青霉素耐药率高，对万古霉素和利奈唑胺敏感性高。革兰阴性杆菌中大肠埃希菌和肺炎克雷伯菌对青霉素类药物耐药率高，对亚胺培南、美罗培南耐药率低，大肠埃希菌的耐药性总体显著高于肺炎克雷伯菌和阴沟肠杆菌。结论骨伤科分泌物检出以革兰阳性菌为主，其中金黄色葡萄球菌大约占三分之一。临床上应结合药敏试验和病人病情，选择合适的药物进行抗感染治疗。 |
| 英文摘要: |
| Objective To analyze the distribution and drug resistance of pathogenic bacteria in orthopedic wound secretions, andprovide a basis for the rational use of antibiotics in clinical practice.Methods A total of 586 positive strains were collected from theDepartment of Orthopedics and Traumatology of the Inner Mongolia Autonomous Region People's Hospital from January 2017 to De.cember 2020, and the VITEK 2 Comapct 60 automatic bacterial identification and drug susceptibility analysis system was used to ana.lyze the bacterial identification and drug susceptibility.Results 586 positive strains were isolated, including 408 gram-positive bacte. ria, accounting for 69.62%, and 171 gram-negative bacteria, accounting for 29.18%. The top three gram-positive cocci detected were Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecalis. The top three gram-negative bacilli detected were Esche. richia coli, Enterobacter cloacae and Klebsiella pneumoniae. The results of the drug susceptibility test showed that Staphylococcus aureus and Staphylococcus epidermidis were highly resistant to penicillin and highly sensitive to vancomycin and linezolid. Among the gram-negative bacilli, Escherichia coli and Klebsiella pneumoniae have high resistance rates to penicillin but low resistance rates to imipenem and meropenem. The overall resistance rate of Escherichia coli is significantly higher than that of Klebsiella pneumoniae and Enterobac. ter cloacae.Conclusions Orthopedic secretions were mainly detected by gram-positive bacteria, of which Staphylococcus aureus ac. counted for approximately one-third. Clinically, the appropriate drug should be selected for anti-infective treatment based on the drug susceptibility test and the patient's condition. |
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