我院开放性地震伤的细菌学调查及抗感染药选择
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摘要
目的:了解开放性地震伤易感细菌种类及敏感药物。方法:对开放性地震伤创面进行细菌检测及药敏试验,用Excel 2003分析细菌培养结果和药敏试验结果。结果:1172份地震伤病历中,外伤/伤口类患者占总数的93.9%,而伤口明显感染者132例。感染病例中开放性骨折占63%,软组织外伤占28%,脑外伤占9%。所送培养标本阳性率为69%,培养结果显示革兰阴性(G-)菌占85.6%,居主导地位,以鲍曼不动杆菌、阴沟肠杆菌、大肠埃希菌为主。培养出的细菌耐药性较高。结论:开放性地震伤创面在医院内易受到G-菌的污染,彻底的清创和正确选用抗感染药可减少开放性地震伤患者的感染。
OBJECTIVE:To study the bacteria strains and susceptible drugs in open wound in patients with earthquake injury. METHODS:Bacteriological test and the drug susceptibility test were conducted for earthquake injury patients with open wound and the results of bacterial culture and the drug susceptibility test were analyzed using Excel 2003. RESULTS:Of the 1 172 earthquake injury cases,the patients with trauma / wounds represented 93.9%,the wound had obvious infection in 132 cases; of the infected cases,the proportions of patients with open fractures,soft tissue injuries and traumatic brain injury accounted for 63%,28% and 9%,respectively. The positive rate of the bacterial culture was 69%,and gram-negative of bacteria which accounted for 85.6% took the lead,chiefly Acinetobacter baumanii,Enterobacter cloacae and Escherichia coli. The results showed bacterial drug resistance was on the high side. CONCLUSION:The open wounds in patients with earthquake injury are likely to be infected with gram negative organisms. Debridement and correct choice of anti-infective drugs are needed to reduce the risk of wound infection,
OBJECTIVE:To study the bacteria strains and susceptible drugs in open wound in patients with earthquake injury. METHODS:Bacteriological test and the drug susceptibility test were conducted for earthquake injury patients with open wound and the results of bacterial culture and the drug susceptibility test were analyzed using Excel 2003. RESULTS:Of the 1 172 earthquake injury cases,the patients with trauma / wounds represented 93.9%,the wound had obvious infection in 132 cases; of the infected cases,the proportions of patients with open fractures,soft tissue injuries and traumatic brain injury accounted for 63%,28% and 9%,respectively. The positive rate of the bacterial culture was 69%,and gram-negative of bacteria which accounted for 85.6% took the lead,chiefly Acinetobacter baumanii,Enterobacter cloacae and Escherichia coli. The results showed bacterial drug resistance was on the high side. CONCLUSION:The open wounds in patients with earthquake injury are likely to be infected with gram negative organisms. Debridement and correct choice of anti-infective drugs are needed to reduce the risk of wound infection,
引文
[1]黄寿清,张楚南,李向阳,等.开放性骨折创面处理与创面感染的关系[J].中国感染控制杂志,2003,2(3):170.
[2]王娜,刘玉珂,丁继光,等.开放性骨折创面感染的常见病原菌及药敏分析[J].中医正骨,2007,19(11):23.
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[5]胡必杰,陶黎黎.地震灾害伤员的常见感染类型和预治对策[J].中华医院感染学杂志,2008,18(6):742.
[6]Bulut M,Fedakar R,Akkose S,et al.Medical experi-ence of a university hospital in Turkey after the1999Marmara earthquake[J].Emerg Med J,2000,22(7):494.
[7]包晓航,张晓东,杨天德.地震灾害中的创伤类型、死亡原因和急救处理[J].中国医药指南杂志,2008,6(5):7.
[2]王娜,刘玉珂,丁继光,等.开放性骨折创面感染的常见病原菌及药敏分析[J].中医正骨,2007,19(11):23.
[3]Olson SA,California S.Open fractures of the tibial shaft[J].J Bone Joint Surg,1996,78(9):1428.
[4]张伯松,翟桂华,张亚莲,等.开放性骨折创面的细菌学研究[J].中华医院感染学杂志,1999,9(3):143.
[5]胡必杰,陶黎黎.地震灾害伤员的常见感染类型和预治对策[J].中华医院感染学杂志,2008,18(6):742.
[6]Bulut M,Fedakar R,Akkose S,et al.Medical experi-ence of a university hospital in Turkey after the1999Marmara earthquake[J].Emerg Med J,2000,22(7):494.
[7]包晓航,张晓东,杨天德.地震灾害中的创伤类型、死亡原因和急救处理[J].中国医药指南杂志,2008,6(5):7.
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