中国汶川地震伤员骨科开放性伤口的细菌学分析
|
摘要
目的:了解汶川地震伤员骨科开放性伤口的菌谱特点及其药敏试验结果,指导抗菌药物合理应用。方法:收集148例骨科开放性伤口地震伤员,男71例,女77例;年龄2～82岁,平均40.4岁;其中被埋37例,被埋时间为5min～102h。对340份伤口渗出物标本进行细菌培养和药物敏感试验。结果:148例地震伤员伤口感染率为66.2%。340份标本分离培养出257株病原菌,其中革兰氏阴性菌占77.8%,革兰氏阳性菌占20.6%。汶川地震伤员骨科开放性伤口感染细菌排在前5位的细菌依次是大肠埃希氏菌(16.3%)、鲍曼/溶血不动杆菌(16.0%)、金黄色葡萄球菌(13.6%)、铜绿假单胞菌(12.5%)和阴沟肠杆菌(8.6%)。结论:微生物研究者、感染控制人员和临床医生都应重视伤口渗出物的药敏结果,合理使用抗菌药物,提高抗生素使用水平。
Objective:To observe the bacterial characteristic of orthopedic open wounds injured in Wenchuan earthquake and their drug resistant pattern for reasonable application of antibiotics.Methods:A total of 340 secretion specimens isolated from 148 cases of orthopedic open wounds of earthquake victims were analyzed.Among the patients,71 patients were male and 77 patients were female,ranging in age from 2 to 82 years,with an average of 40.4 years.Thirty seven patients were detained under the ground ranged from 5 min to 102 h.The 340 specimens of exudation in the wound were collected for bacterial culture and drug sensitivity tests.Results:The infection rate of 148 cases was 66.2 percent.Two hundred and fifty seven pathogens were isolated from 340 secretion specimen,including gram negative bacteria accounted for 77.8%,gram positive bacteria accounted for 20.6%.The most frequent pathogens isolated from secretion culture in Wenchuan earthquake survivors were Escherichia coli(16.3%),Acinetobacter baumannii(16.0%),Staphylococcus aureus(13.6%),Pseudomonas aeruginosa (12.5%) and Enterobacter cloacae (8.6%).Conclusion:The drug sensitivity test of exudation as well as exact application of antibiotics should be highly payed attention to by doctors in order to reduce the occurrence of bacterial resistance.
Objective:To observe the bacterial characteristic of orthopedic open wounds injured in Wenchuan earthquake and their drug resistant pattern for reasonable application of antibiotics.Methods:A total of 340 secretion specimens isolated from 148 cases of orthopedic open wounds of earthquake victims were analyzed.Among the patients,71 patients were male and 77 patients were female,ranging in age from 2 to 82 years,with an average of 40.4 years.Thirty seven patients were detained under the ground ranged from 5 min to 102 h.The 340 specimens of exudation in the wound were collected for bacterial culture and drug sensitivity tests.Results:The infection rate of 148 cases was 66.2 percent.Two hundred and fifty seven pathogens were isolated from 340 secretion specimen,including gram negative bacteria accounted for 77.8%,gram positive bacteria accounted for 20.6%.The most frequent pathogens isolated from secretion culture in Wenchuan earthquake survivors were Escherichia coli(16.3%),Acinetobacter baumannii(16.0%),Staphylococcus aureus(13.6%),Pseudomonas aeruginosa (12.5%) and Enterobacter cloacae (8.6%).Conclusion:The drug sensitivity test of exudation as well as exact application of antibiotics should be highly payed attention to by doctors in order to reduce the occurrence of bacterial resistance.
引文
[1]周铁丽,李超,戴美杰.嗜水气单胞菌引起伤口感染一例.中国骨伤,2002,15(2):91.
[2]倪雨星.革兰氏阴性杆菌β内酰胺酶的耐药性问题.中华检验医学杂志,2001,24(4):202203.
[3]陈莉明,郭天康,张浩军,等.2002-2005年病原菌与耐药性分析.中华医院感染学杂志,2008,18(12):17511753.
[4]董守池,马海霞.216例伤口分泌物细菌培养及药敏试验结果分析.河南外科学杂志,2002,8(6):85.
[5]程烜,马小明,梁勤.伤口分泌物分离培养出肠杆菌科细菌的耐药性分析.中国实验诊断学,2003,7(4):350351.
[6]葛德珊,冼翠琴,黄玉环.肠杆菌科细菌的耐药性变迁.国际医药卫生导报,2005,11(4):9495.
[7]陈文昭,席敏,陶传敏,等.克林霉素诱导实验在金黄色葡萄球菌药物敏感实验中的应用.预防医学情报杂志,2008,24(12):981983.
[8]鲍宏达,徐白莹,刘畅,等.金黄色葡萄球菌的耐药性分析及基因分型研究.中国微生态学杂志,2009,21(1):4244.
[9]吴伟元,陈民钧,王辉.阴沟肠杆菌去阻遏持续高产AmpC酶和超广谱β内酰胺酶(ESBLs)的检测.中国临床药理学杂志,2001,17(2):104.
[2]倪雨星.革兰氏阴性杆菌β内酰胺酶的耐药性问题.中华检验医学杂志,2001,24(4):202203.
[3]陈莉明,郭天康,张浩军,等.2002-2005年病原菌与耐药性分析.中华医院感染学杂志,2008,18(12):17511753.
[4]董守池,马海霞.216例伤口分泌物细菌培养及药敏试验结果分析.河南外科学杂志,2002,8(6):85.
[5]程烜,马小明,梁勤.伤口分泌物分离培养出肠杆菌科细菌的耐药性分析.中国实验诊断学,2003,7(4):350351.
[6]葛德珊,冼翠琴,黄玉环.肠杆菌科细菌的耐药性变迁.国际医药卫生导报,2005,11(4):9495.
[7]陈文昭,席敏,陶传敏,等.克林霉素诱导实验在金黄色葡萄球菌药物敏感实验中的应用.预防医学情报杂志,2008,24(12):981983.
[8]鲍宏达,徐白莹,刘畅,等.金黄色葡萄球菌的耐药性分析及基因分型研究.中国微生态学杂志,2009,21(1):4244.
[9]吴伟元,陈民钧,王辉.阴沟肠杆菌去阻遏持续高产AmpC酶和超广谱β内酰胺酶(ESBLs)的检测.中国临床药理学杂志,2001,17(2):104.
版权所有：© 2023 中国地质图书馆 中国地质调查局地学文献中心