CAJ | 학술논문

目的：分析创面感染病原菌的分布及耐药性，为临床治疗创面感染合理用药及减少耐药菌产生提供科学依据。方法对某院2011年6月—2014年4月患者创面感染标本中检出的病原菌资料进行回顾性分析。结果创面标本中共检出965株病原菌，感染部位以四肢为主（50．47％）；科室分布以骨外科为主（44．97％）；感染诊断以创伤及切口感染较多，分别占47．98％、36．48％。检出的病原菌中革兰阳性菌占37．20％，革兰阴性菌占59．59％，真菌占3．21％。主要革兰阳性菌对万古霉素、替考拉宁和利奈唑胺高度敏感，主要革兰阴性菌对头孢哌酮／舒巴坦、哌拉西林／他唑巴坦、亚胺培南和美罗培南敏感度较高外，对大多数常用的抗菌药物均有较高的耐药率。结论创面感染患者主要来源于骨科，以创伤与手术切口感染为主，且常见革兰阳性及阴性菌的耐药率均较高。外科医生尤其是骨科医生应加强病原菌培养及药敏监测，合理选用抗菌药物，同时加强手术部位感染的防控，以降低感染率和减少耐药菌的发生。
목적：분석창면감염병원균적분포급내약성，위림상치료창면감염합리용약급감소내약균산생제공과학의거。방법대모원2011년6월—2014년4월환자창면감염표본중검출적병원균자료진행회고성분석。결과창면표본중공검출965주병원균，감염부위이사지위주（50．47％）；과실분포이골외과위주（44．97％）；감염진단이창상급절구감염교다，분별점47．98％、36．48％。검출적병원균중혁란양성균점37．20％，혁란음성균점59．59％，진균점3．21％。주요혁란양성균대만고매소、체고랍저화리내서알고도민감，주요혁란음성균대두포고동／서파탄、고랍서림／타서파탄、아알배남화미라배남민감도교고외，대대다수상용적항균약물균유교고적내약솔。결론창면감염환자주요래원우골과，이창상여수술절구감염위주，차상견혁란양성급음성균적내약솔균교고。외과의생우기시골과의생응가강병원균배양급약민감측，합리선용항균약물，동시가강수술부위감염적방공，이강저감염솔화감소내약균적발생。
Objective To analyze the distribution and antimicrobial resistance of pathogenic strains in wound infec-tion,and provide scientific evidence for rational use of antimicrobial agents in treatment of wound infection as well as reducing the emergence of drug-resistant organisms.Methods Data about pathogenic strains isolated from wound specimens of patients with wound infection in a hospital between June 2011 and April 2014 were analyzed retrospectively.Results A total of 965 pathogenic strains were isolated from wound specimens,the main infection sites were limbs(50.47%);infected patients mainly distributed in department of orthopaedic surgery(44.97%);trauma and incisional wound infection were the major infection types(47.98%,36.48%,respectively).Among iso-lated pathogens,gram-positive bacteria,gram-negative bacteria,and fungi accounted for 37.20%,59.59%,and 3.21 % respectively.The main gram-positive bacteria were highly susceptible to vancomycin,teicoplanin,and linezolid,the main gram-negative bacteria were highly resistant to most commonly used antimicrobial agents except cefoperazone/sulbactam,piperacillin/ tazobactam,imipenem,and meropenem.Conclusion Patients with wound infection are mainly distributed in department of orthopedics,the main infection types are trauma and surgical site infection,antimicrobial resistant rates of the major gram-positive and gram-negative bacteria are both high.Sur-geons,especially orthopedics surgeons,should pay attention to the culture of pathogens and monitoring of antimi-crobial susceptibility,use antimicrobial agents rationally,and strengthen the prevention and control of surgical site infection,so as to reduce the infection incidence and occurrence of drug-resistant organisms.