CAJ | 학술논문

目的：通过对手外伤感染创面细菌培养结果进行菌种分布和耐药情况分析，为手外科感染控制及临床合理用药提供依据。方法收集沈阳医学院附属中心医院2010年1月1日—2014年12月31日手外伤感染患者的分泌物标本进行细菌培养，分离致病菌，对其菌种分布及耐药情况进行分析。结果共分离细菌915株，其中革兰氏阴性杆菌738株，占80.6%，革兰氏阳性球菌169株，占18.5%；真菌8株，占0.9%。致病菌中以铜绿假单胞菌检出率最高258株（28.2%），其次为金黄色葡萄球菌97株（10.6%），鲍曼不动杆菌67株（7.3%）。肠杆菌科细菌对美罗培南、亚胺培南和头孢哌酮/舒巴坦耐药率较低，分别是5.1％，6.8％和9.2％；非发酵菌对多粘菌素B和头孢哌酮/舒巴坦耐药率较低，分别是4.2％和7.5％；葡萄球菌和链球菌/肠球菌属对万古霉素敏感。结论手外科感染的菌种分布和耐药情况有自己的特点，不同于其他部位的感染，应将细菌培养作为抗菌药物使用的参考。
목적：통과대수외상감염창면세균배양결과진행균충분포화내약정황분석，위수외과감염공제급림상합리용약제공의거。방법수집침양의학원부속중심의원2010년1월1일—2014년12월31일수외상감염환자적분비물표본진행세균배양，분리치병균，대기균충분포급내약정황진행분석。결과공분리세균915주，기중혁란씨음성간균738주，점80.6%，혁란씨양성구균169주，점18.5%；진균8주，점0.9%。치병균중이동록가단포균검출솔최고258주（28.2%），기차위금황색포도구균97주（10.6%），포만불동간균67주（7.3%）。장간균과세균대미라배남、아알배남화두포고동/서파탄내약솔교저，분별시5.1％，6.8％화9.2％；비발효균대다점균소B화두포고동/서파탄내약솔교저，분별시4.2％화7.5％；포도구균화련구균/장구균속대만고매소민감。결론수외과감염적균충분포화내약정황유자기적특점，불동우기타부위적감염，응장세균배양작위항균약물사용적삼고。
Objective To investigate the distribution of common species of pathogens causing infections in hand surgery department and analyze the drug resistance so as to provide basis for the clinical study. Methods The pathogens causing infections in hand surgery department from 2010.01.01 to 2014.12.31 were analyzed for their drug sensitivity with MIC method, and the results were carried out for statistical analysis. Results Among the 915 pathogens isolated, there were 738 (80.6%) strains of gram-negative bacteria,;there were 169(18.5%) strains of gram-positive bacteria, and there were 8(0.9%) strains of fungi. Among which Pseudomonas aeruginosa was the dominant, 258 strains (28.2%), followed by Staphylococcus aureus, 97 strains (10.6%) and Acinetobacter baumannii 67 strains (7.3%). The enterobacteriaceae were most susceptible to imipenem, meropenem and cefoperazone/sulbactam, with the drug resistance rate of 5.1%, 6.8%, and 9.2; The non -fermentative bacilli were most susceptible to polymexin B and cefoperazone/sulbactam, with the drug resistance rate of 4.2%, and 7.5%; the gram-positive bacteria were most susceptible to vancomycin. Conclusion Hand infection has its own pathogen distribution and drug resistance characters, not the same like other infections, so it is necessary for the hospital to perform the symptomatic treatment based on the drug susceptibility testing.