CAJ | 학술논문

[目的]分析骨科患者伤口分泌物病原菌分布及药敏试验，为骨科临床医生合理治疗及控制医院感染提供依据。[方法]将2009年1月至2013年12月我院277例门诊和住院骨科患者的伤口分泌物标本接种于血平板、巧克力平板，按《全国临床检验操作规程》3版要求分离纯菌，用法国生物梅里埃公司API鉴定和K-B法做药敏试验。[结果]185株伤口分泌物病原菌中检出前5位的病原菌是阴沟肠杆菌36株占19.5%，金黄色葡萄球菌32株占17.3%，表皮葡萄球菌29株占15.7%，大肠埃希菌26株占14.1%，铜绿假单胞菌20株占10.8%。大肠埃希菌26株，产ESBLs 阳性占26.9%(7/26株)，主要革兰阴性杆菌对氨苄西林和头孢唑林的耐药率最高；未发现革兰氏阴性杆菌对头孢哌酮/舒巴坦和亚胺培南耐药。耐甲氧西林金黄色葡萄球菌检出率为21.9%，耐甲氧西林表皮葡萄球菌检出率为20.7%，且对青霉素的耐药率较高，未发现耐万古霉素的葡萄球菌。[结论]阴沟肠杆菌和金黄色葡萄球菌是创伤患者伤口优势菌种，而且细菌耐药性高；临床医生应合理制定治疗方案，选择使用有效的抗菌药物。
[목적]분석골과환자상구분비물병원균분포급약민시험，위골과림상의생합리치료급공제의원감염제공의거。[방법]장2009년1월지2013년12월아원277례문진화주원골과환자적상구분비물표본접충우혈평판、교극력평판，안《전국림상검험조작규정》3판요구분리순균，용법국생물매리애공사API감정화K-B법주약민시험。[결과]185주상구분비물병원균중검출전5위적병원균시음구장간균36주점19.5%，금황색포도구균32주점17.3%，표피포도구균29주점15.7%，대장애희균26주점14.1%，동록가단포균20주점10.8%。대장애희균26주，산ESBLs 양성점26.9%(7/26주)，주요혁란음성간균대안변서림화두포서림적내약솔최고；미발현혁란씨음성간균대두포고동/서파탄화아알배남내약。내갑양서림금황색포도구균검출솔위21.9%，내갑양서림표피포도구균검출솔위20.7%，차대청매소적내약솔교고，미발현내만고매소적포도구균。[결론]음구장간균화금황색포도구균시창상환자상구우세균충，이차세균내약성고；림상의생응합리제정치료방안，선택사용유효적항균약물。
[Objective] To analyse the orthopaedics patients’wound secreta pathogenic bacteria distribution and drug al ergy test, and offer foundation for clinical orthopaedics doctors’reasonable treatment and control ing hospital infection. [Method] Make inoculation of the wound secreta sample on the blood plate and chocolate plate, separate the pure bacteria under“National Clinical Test Operational Rules”of 3d issue, and make drug al ergy with French BioMerieux API Authentication and K-B method. [Result] The first 5 pathogenic bacteria detected in 189 strains of wound secreta are: 36 strains of enterobacter cloacae, occupying 19.5%;32 strains of staphylococcus aureus, occupying 17.3%;29 strains of staphylococcus epidermidis, 15.7%;26 strains of Escherichia coli, 14.1%; 20 strains of pseudomonas aeruginosa, 10.8%; the 26 strains of Escherichia coli have positive ESBLs 26.9%(7/26strains); the gram negative bacil i has highest drug resistance rates to ampicil in and cefazolin, without resistance to cefoperazone/sulbactam and imipenem. The detection rate is 21.9% for methoicil in-resistant staphylococcus epidermidis; the detection rate of methicil in-resistant staphylococcus epeidermidis is 20.7%,with highest resistant rate to penicil in, without staphylococcus resisting vancomycin. [Conclusion] The enterobacter cloacae and staphylococcus are the advantageous bacteria of wounds, with high drug resistance;the clinical doctors shal reasonably make out treatment plan and select effective anti-bacterial drugs.