CAJ | 학술논문

目的：了解该院骨科患者伤口感染的病原菌分布及耐药性趋势，为临床合理使用抗菌药物提供依据。方法采用VITEK 2 Compact自动细菌鉴定仪进行细菌鉴定及药敏试验，分析骨科患者伤口分泌物病原菌分布及耐药情况。结果从3317份标本中共分离出细菌603株，其中革兰阳性球菌占56．4％，革兰阴性杆菌占40．8％，假丝酵母菌占2．8％。前7种菌种依次为表皮葡萄球菌（15．4％）、铜绿假单胞菌（11．0％）、金黄色葡萄球菌（7．6％）、溶血葡萄球菌（7．3％）、粪肠球菌（6．8％）、阴沟肠杆菌（6．3％）和大肠埃希菌（3．5％）。耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌分别为24．0％和38．7％，大肠埃希菌产超广谱β‐内酰胺酶发生率60．0％。结论骨科伤口感染病原菌以革兰阳性球菌为主，内源性正常菌群和来自周围环境中的条件致病菌已成为骨科伤口感染的主要致病菌，万古霉素及亚胺培南仍保持较高的抗菌活性。
목적：료해해원골과환자상구감염적병원균분포급내약성추세，위림상합리사용항균약물제공의거。방법채용VITEK 2 Compact자동세균감정의진행세균감정급약민시험，분석골과환자상구분비물병원균분포급내약정황。결과종3317빈표본중공분리출세균603주，기중혁란양성구균점56．4％，혁란음성간균점40．8％，가사효모균점2．8％。전7충균충의차위표피포도구균（15．4％）、동록가단포균（11．0％）、금황색포도구균（7．6％）、용혈포도구균（7．3％）、분장구균（6．8％）、음구장간균（6．3％）화대장애희균（3．5％）。내갑양서림금황색포도구균화응고매음성포도구균분별위24．0％화38．7％，대장애희균산초엄보β‐내선알매발생솔60．0％。결론골과상구감염병원균이혁란양성구균위주，내원성정상균군화래자주위배경중적조건치병균이성위골과상구감염적주요치병균，만고매소급아알배남잉보지교고적항균활성。
Objective To comprehend the pathogenic bacteria distributions and drug resistance tendencies and to provide the basis of rational use for the antimicrobial drugs in the clinical .Methods VITEK 2 Compact Automatic bacteria identification equipment was used to identify the bacteria and to accomplish the drug sensitive test .The path‐ogenic bacteria distributions and drug resistance circumstances were analyzed for the wound secretion in the orthope‐dic patients .Results 603 strains bacteria were separated from 3 317 specimens and the gram positive bacteria ac‐counted for 56 .4% ,the gram negative bacteria accounted for 40 .8% ,the candida is 2 .8% .In front of the seven kinds of strains are the epidermis staphylococcus(15 .4% ) ,the pseudomonas aeruginosa(11 .0% ) ,the staphylococcus au‐reus(7 .6% ) ,the hemolysis staphylococcus(7 .3% ) ,the Enterococcus faecalis(6 .8% ) ,the sewer enterobacter(6 .3% ) and the E .coli pin(3 .5% ) in the order .The methicillin‐resistants aureus bacteria and the coagulase negative staphy‐lococcus aureus is 24 .0% and 38 .7% respectively .The incidence rate of E coli pin to produce super broad spectrumβ‐lactamase (ESBLs) is 60 .0% .Conclusion The gram positive bacteria are main bacteria in the pathogenic bacteria of the orthopedic wound infection .The endogenous normal flora or the conditioned pathogen from the surrounding environment has become the main pathogenic bacteria of the orthopedic wound infection .The vancomycin and imipen‐em still keep higher antimicrobial activity .