CAJ | 학술논문

目的了解开放性手及前臂创伤患者常见病原菌的分布与耐药情况,为指导临床抗生素药物的合理使用提供参考依据.方法收集骨科病房内开放性手及前臂创伤感染患者200例,采集病灶伤口分泌物标本进行细菌培养鉴定,并对检出的病原菌按K-B法做体外药物敏感试验.结果分离出病原菌196株,其中革兰阳性细菌82株(41.84％),主要包括金黄色葡萄球菌、表皮葡萄球菌、肠球菌等；革兰阴性细菌114株(58.16％),主要包括大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌等.药物敏感结果显示革兰阳性细菌对常用抗生素药物耐药率最低的是万古霉素；革兰阴性细菌对常用抗生素药物耐药率最低的是亚胺培南；革兰阳性细菌和阴性细菌对青霉素类抗生素均耐药率高.有4例患者伤口分泌物中未分离出病原菌.结论骨科开放性手及前臂创伤感染患者多见,患者细菌耐药情况仍是临床的严峻问题.因此应加强骨科患者的细菌培养及耐药性监测,合理使用抗生素,从而有效降低骨科患者感染的发生率.
목적 료해개방성수급전비창상환자상견병원균적분포여내약정황,위지도림상항생소약물적합리사용제공삼고의거.방법 수집골과병방내개방성수급전비창상감염환자200례,채집병조상구분비물표본진행세균배양감정,병대검출적병원균안K-B법주체외약물민감시험.결과 분리출병원균196주,기중혁란양성세균82주(41.84％),주요포괄금황색포도구균、표피포도구균、장구균등；혁란음성세균114주(58.16％),주요포괄대장애희균、동록가단포균、포만불동간균등.약물민감결과현시혁란양성세균대상용항생소약물내약솔최저적시만고매소；혁란음성세균대상용항생소약물내약솔최저적시아알배남；혁란양성세균화음성세균대청매소류항생소균내약솔고.유4례환자상구분비물중미분리출병원균.결론 골과개방성수급전비창상감염환자다견,환자세균내약정황잉시림상적엄준문제.인차응가강골과환자적세균배양급내약성감측,합리사용항생소,종이유효강저골과환자감염적발생솔.
Objective To investigate the distribution of pathogens and the development of drug resistance in patients with open hand and forearm trauma and infection,and provide scientific basis for antibiotics selection.Methods A total of 200 patients from the orthopedics ward who sustained infections after open hand and forearm trauma were involved.Secretion from the open wound was collected for bacteria identification,drug susceptibility analysis and resistance detection by the K-B method.Results One hundred and ninety-six pathogen strains were detected.82 (41.84％) of these were gram-positive bacteria including staphylococcus aureus,staphylococcus epidermidis,intestinal coccus,etc.114 (58.16％) were gram-negative bacteria including Escherichia coli,pseudomonas aeruginosa,acinetobacter baumannii,etc.The results of drug susceptibility test showed that the lowest antibiotics resistance was vancomycin in gram-positive bacteria.The lowest antibiotics resistance was imipenem in gram-negative bacteria.The highest drug resistance was penicillin for both grampositive and gram-negative bacteria.However,no pathogen was isolated from 4 patients.Conclusion Bacterial infection is common in open hand and forearm trauma patients.Currently,bacterial resistance issue is still a serious clinical problem.Strengthening bacteria culture,monitoring drug resistance,and appropriate antibiotics selection could reduce orthopaedic infection rates.