中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2009年
12期
1002-1005
,共4页
外科伤口感染%细菌%耐药
外科傷口感染%細菌%耐藥
외과상구감염%세균%내약
Surgical wound infection%Bacteria%Antibacterial agents resistance
目的 了解我国创伤及术后伤口感染患者细菌分布及耐药状况.方法 采用纸片法、MIC法或E-TEST法,使用WHONET5.4软件进行分析,对卫生部全国细菌耐药性监测网所属86家三级甲等医院2006年6月1日至2007年5月31日分离的创伤及术后感染分泌物菌株进行分析.结果 (1)共分离细菌2125株,包括革兰阳性(G~+)菌994株(46.8%)和革兰阴性(G~-)菌1131株(53.2%),前三位细菌分别为葡萄球菌(780株、36.7%)、大肠埃希菌(338株、15.9%)和铜绿假单胞菌(231株、10.9%);(2)头孢西丁耐药的金黄色葡萄球菌和凝固酶阴性葡萄球菌的检出率分别为38.2%和84.1%,未发现对糖肽类耐药的葡萄球菌.(3)大肠埃希菌对三代、四代头孢萧素的耐药率约为60%～65%,对氟喹诺酮的耐药率为70%.(4)成人患者分离的葡萄球菌、大肠埃希菌对氨基糖苷类和喹诺酮类药物的耐药率明显高于儿童;(5)门急诊来源的葡萄球菌对头孢菌素、喹诺酮类、氨基糖苷类的耐药率明显低于住院患者来源细菌. 结论创伤及术后伤口感染的主要致病菌为葡萄球菌、大肠埃希菌和铜绿假单胞菌,MRSA检出率较同期整体监测细菌低,大肠埃希菌对头孢菌素耐药率较整体监测细菌高;成人分离菌耐药率高于儿童,门诊高于住院患者.
目的 瞭解我國創傷及術後傷口感染患者細菌分佈及耐藥狀況.方法 採用紙片法、MIC法或E-TEST法,使用WHONET5.4軟件進行分析,對衛生部全國細菌耐藥性鑑測網所屬86傢三級甲等醫院2006年6月1日至2007年5月31日分離的創傷及術後感染分泌物菌株進行分析.結果 (1)共分離細菌2125株,包括革蘭暘性(G~+)菌994株(46.8%)和革蘭陰性(G~-)菌1131株(53.2%),前三位細菌分彆為葡萄毬菌(780株、36.7%)、大腸埃希菌(338株、15.9%)和銅綠假單胞菌(231株、10.9%);(2)頭孢西丁耐藥的金黃色葡萄毬菌和凝固酶陰性葡萄毬菌的檢齣率分彆為38.2%和84.1%,未髮現對糖肽類耐藥的葡萄毬菌.(3)大腸埃希菌對三代、四代頭孢蕭素的耐藥率約為60%～65%,對氟喹諾酮的耐藥率為70%.(4)成人患者分離的葡萄毬菌、大腸埃希菌對氨基糖苷類和喹諾酮類藥物的耐藥率明顯高于兒童;(5)門急診來源的葡萄毬菌對頭孢菌素、喹諾酮類、氨基糖苷類的耐藥率明顯低于住院患者來源細菌. 結論創傷及術後傷口感染的主要緻病菌為葡萄毬菌、大腸埃希菌和銅綠假單胞菌,MRSA檢齣率較同期整體鑑測細菌低,大腸埃希菌對頭孢菌素耐藥率較整體鑑測細菌高;成人分離菌耐藥率高于兒童,門診高于住院患者.
목적 료해아국창상급술후상구감염환자세균분포급내약상황.방법 채용지편법、MIC법혹E-TEST법,사용WHONET5.4연건진행분석,대위생부전국세균내약성감측망소속86가삼급갑등의원2006년6월1일지2007년5월31일분리적창상급술후감염분비물균주진행분석.결과 (1)공분리세균2125주,포괄혁란양성(G~+)균994주(46.8%)화혁란음성(G~-)균1131주(53.2%),전삼위세균분별위포도구균(780주、36.7%)、대장애희균(338주、15.9%)화동록가단포균(231주、10.9%);(2)두포서정내약적금황색포도구균화응고매음성포도구균적검출솔분별위38.2%화84.1%,미발현대당태류내약적포도구균.(3)대장애희균대삼대、사대두포소소적내약솔약위60%～65%,대불규낙동적내약솔위70%.(4)성인환자분리적포도구균、대장애희균대안기당감류화규낙동류약물적내약솔명현고우인동;(5)문급진래원적포도구균대두포균소、규낙동류、안기당감류적내약솔명현저우주원환자래원세균. 결론창상급술후상구감염적주요치병균위포도구균、대장애희균화동록가단포균,MRSA검출솔교동기정체감측세균저,대장애희균대두포균소내약솔교정체감측세균고;성인분리균내약솔고우인동,문진고우주원환자.
Objective To determine the bacterial composition and resistance of wound infections in China. Methods Disc diffusion test,MIC test and E-test were used to detect the antimicrohial resistance of bacterial isolates from wound secretions.WHONET 5.4 was applied for analysis of the bacterial sensitive data from 86 domestic tertiary hospitals from June 1,2006 to May 31,2007. Results (1)2125 bacterial strains were coileeted in the survey period,which included 994 strains (46.8%) of Gram positive and 1131 strains (53.2%) of Gram negative bacteria,Staphylococcus(780 strains,36.7%),E.coli(338 strains,15.9%) and Pseudomonas aeruginosa (231 strains,10.9%)were the most common isolates.(2)38.2% and 84.1% of Staphylococcus aureus and Staphylococcus epidermidis were methicillin-resistant.respectively.No Staphylococcus strain was resistant to vancomycin or teicoplanin.(3)ESBLs positive rate of E.coli was about 60%,while the resistant rate to quinolones Was about 70%.(4)The resistant rates of Staphylococci and E.coli isolated from adults to aminoglyeoside and quinolones were higher than those from children.(5)The resistant rates of Staphylococei to cephalosporin,aminoglyeoside and quinolones from inpatients were higher than those from out-patients. Conclusion Staphylococci,E.coli and Pseudomonas aeriginoso were among the most common organisms isolated from wound infections.The ESBLs positive rate of E.coli from wound infections was higher than that from all specimen bacteria found in other surveys performed during the same period and the methicillin resistant Staphylococci were less than that.
