骨科感染病原菌谱与抗菌谱3年报告

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1、骨科感染病原菌谱与抗菌谱3年报告作者：王化芬　王晓军　于茜李娜【摘要】　　［目的］了解骨科病人所感染菌群及其耐药性，指导临床正确应用抗生素。［方法］对骨科门诊及病房细菌感染病人的708份分泌物、脓液等标本进行需氧培养，并对检出菌按K-B法做体外药敏实验。［结果］检出致病菌259株，G+菌占％，其中金黄色葡萄球菌％，凝固酶阴性葡萄球菌％；G-菌占％，其中假单胞菌属占％，不动杆菌属占％。药敏显示革兰阳性球菌对青霉素及苯唑青霉素的耐药率逐年升高，对万古霉素的敏感性最高为100％。革兰阴性杆菌对亚胺培南的敏感率最高，3年平均％，对头孢他啶也较

2、敏感，但有逐年下降的趋势，对环丙沙星、阿米卡星、哌拉西林的耐药率较高，分别为％、％、％。［结论］骨科病人感染的病原菌中，G-杆菌占大多数且有上升趋势，G+球菌感染发生率少于G-杆菌，单菌株以金黄色葡萄球菌占首位。对G-球菌可以选用万古霉素、苯唑青霉素、诺氟沙星等；对G-杆菌可以选用亚胺培南、头孢他啶。革兰阴性杆菌引起骨科感染有上升趋势，耐药也较严重，加强感染菌及药敏检测，合理使用抗生素非常必要。【关键词】感染菌耐药率不动杆菌Pathogenicbacteriaanddrugresistanceinorthopedicspatient

3、s:areviewofthepastthreeyears∥　　Abstract：［Objective］Toinvestigatethepathogenicbacteriaanddrugresistanceinorthopedicspatients,soastoguidetheclinicaluseofantibiotics.［Method］70secretionsandpussamplesfromorthopedicoutpatientsandinpatientswereculturedaerobically.Thedetectabl

4、ebacteriaweresubjectedtodrugsensitivitytestinvitrobytheKBassay.［Result］25pathogenicstrainsweredetected,%ofthemwereGrampositive(Staphylococcusaureus,%:coagulasenegativestaphylococci,%),andtheremaining%wereGramnegative(Pseudomonas,.3%;Acinetobacter,.1%).Thedrugresist

5、antrateofGrampositivecoccitopenicillinandoxcillintendedtoraiseoverthethreeyears:however,allthedetectedGrampositivecocciweresensitivetovancomycin(100%).MostGramnegativebacilliweresensitivetoimipenem(%)inthepastthreeyearsandthesensitivitytoceftazidimewasalsohigh;howeve

6、r,thesensitivitytendedtofalloverthepastthreeyears.ThedrugresistantratesofGramnegativebacillitoCiprofIoxacin.amikacinandpiperacillin%.%%respectively.［Conclusion］Gramnegativebacillidominatethepathogenicbacteriainorthopaedicpatientsandtheytendtoincrease.Theincidenceofin

7、fectionsbyGrampositivecocciislowerthanthatofinfectionsbyGramnegativebacilli.Intermsofindividualbacteria,staphylococcusaureusleadsamongallofthesepathogenicbacteria,Vancomycin,OxacillinandNorfloxacinarepreferreddrugsagainstGrampositivecocci,whileimipenemandceftazidimea

8、repreferredforGramnegativeincidenceofinfectionsbyGramnegativebacillitendtoraiseanddrugresistanceofGramnegat