CAJ | 학술논문

目的：掌握医院骨科患者感染病原菌分布，降低和减少骨科患者发生感染的危险性，为临床治疗中抗菌药物的合理使用提供指导。方法选取2011年3月－2013年9月骨科病房患者1000例作为观察对象，对患者伤口分泌物进行收集，严格无菌操作并立即送检，参考《全国临床检验操作规程》对患者送检的痰液、尿液、伤口渗出液等标本进行细菌分离培养纯化，对病原菌的检测和耐药性分析通过全自动微生物鉴定仪和 K‐B试验法进行，采用SPSS19．0进行统计分析。结果调查1000例患者中共348例发生感染，感染率为34．80％；分离出426株病原菌，以革兰阴性菌为主，240株占56．34％；大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌对美罗培南和亚胺培南均无耐药菌检出，对青霉素类抗菌药物耐药率最高。结论骨科感染的影响因素多，不同细菌对同种抗菌药物的敏感性差异很大，因此应严格按照细菌培养结果和耐药试验结果合理应用抗菌药物，降低骨科患者感染率。
목적：장악의원골과환자감염병원균분포，강저화감소골과환자발생감염적위험성，위림상치료중항균약물적합리사용제공지도。방법선취2011년3월－2013년9월골과병방환자1000례작위관찰대상，대환자상구분비물진행수집，엄격무균조작병립즉송검，삼고《전국림상검험조작규정》대환자송검적담액、뇨액、상구삼출액등표본진행세균분리배양순화，대병원균적검측화내약성분석통과전자동미생물감정의화 K‐B시험법진행，채용SPSS19．0진행통계분석。결과조사1000례환자중공348례발생감염，감염솔위34．80％；분리출426주병원균，이혁란음성균위주，240주점56．34％；대장애희균、폐염극뢰백균、포씨불동간균대미라배남화아알배남균무내약균검출，대청매소류항균약물내약솔최고。결론골과감염적영향인소다，불동세균대동충항균약물적민감성차이흔대，인차응엄격안조세균배양결과화내약시험결과합리응용항균약물，강저골과환자감염솔。
OBJECTIVE To understand the distribution of pathogens for orthopedic infections and reduce the risk of infections so as to provide guidance for the rational use of antimicrobial drugs during treatment .METHODS Total‐ly 1000 patients in the orthopedic ward during Mar .2011 to Sep .2013 were enrolled as the observed subjects . The patient wound secretions were collected in accordance with strict aseptic operation and were immediately in‐spected .The bacteria were isolated ,cultured and purified from specimens of sputum ,urine ,wound exudate ,etc . with reference to the National Clinical Laboratory Procedures .The detection and resistance analysis of pathogens was performed with the automated microbial identification system and the KB test .The software SPSS19 .0 was used for statistical analysis . RESULTS Totally 348 out of 1000 cases had infections , the infection rate was 34 .80% .A total of 426 pathogens were detected ,mainly including gram‐negative bacteria (56 .34% ) .No mero‐penem or imipenem‐resistant strains of Escherichia coli ,Klebsiella pneumoniae ,and Acinetobacter baumannii were detected ,while the resistance of these pathogens was the highest to penicillins .CONCLUSION Various fac‐tors influence orthopedic infections and there are large differences in sensitivities between different bacteria to anti‐microbial drugs .Therefore ,clinicians should rationally use antimicrobial drugs in strict accordance with the re‐sults of bacterial culture and drug test so as to reduce infection rates of orthopedic patients .