摘要
目的 :研究骨科感染病原菌谱及耐药情况 ,指导临床正确应用抗菌素。方法 :回顾性分析骨科 12 6例骨科感染病人的伤口分泌物或脓液的细菌培养及药敏实验结果 ,寻找骨科感染细菌与抗菌素之间的关系。结果 :本组共调查 15 4 3例术后患者 ,其中感染 12 6例 ,感染率 8 17%。分离出病原菌 12 6株 ,G+ 菌占 39 6 8% ,其中金黄色葡萄球菌 2 2 2 2 % ,表皮葡萄球菌 9 5 2 % ;G-菌占 6 0 32 % ,其中鲍曼溶血不动杆菌 17 4 6 % ,铜绿假单胞菌14 2 9%。对G+ 球菌 ,万古霉素的敏感度最高 ,对四种G+ 球菌均为 10 0 % ;环丙沙星、复方新诺明、利福平的敏感度次之。亚胺培南对G-杆菌敏感度最高 (均为 10 0 % ) ,环丙沙星、阿米卡星对铜绿假单胞菌均有较好的敏感度。青霉素类、头孢霉素类和红霉素类对G+ 球菌或G-杆菌均不敏感。结论 :骨科感染的病原菌中 ,G-杆菌占大多数 ,其中鲍曼溶血不动杆菌占首位 ;G+ 球菌感染发生率少于G-杆菌 ,单菌株以金黄色葡萄球菌占首位。临床骨科预防性使用抗菌素 ,对G+ 球菌可以选用万古霉素、喹诺酮类、复方新诺明和利福平等 ;对G-杆菌可以选用亚胺培南、喹诺酮类和氨基糖甙类。喹诺酮类对于G+ 球菌和G-杆菌均有良好的敏感度 ,在临床骨科预防性使用抗菌素时可作为首选。
Objective： To investigate the characteristics of post - operative infection pathogens tables and drug resistance of germs cultivation to guide the use of antibiotics in clinics. Method： A retrospective study about the germs cultivation of wound secretion or pus and drug resistance of germs to find the relation between familiar infetion bacterias and antibiotics. Results： 1543 patients were investigated, in which 126 accompanied with infections （8.17%）. 126 kinds pathogens were got, including 39.68% Gram- posive bacteria among which Staphylococcus aureus account for 22.22%, and staphylococcus epidermidis 9.52%; Gram- negative bacteria 60.32% among which acinetobacter haemolyticus bauamnnii is 17.46%, and pseudomonas aeruginosa 14.29%. In the treatment of Gram positive genus infection, vancomycin showed the best efficacy against all 4 kinds germs with total 100% sensitivity; ciprofloxacin, compound sulfamethoxazole and rifampicin also showed favorable efficacy. For the familiar Gram negative germs, however, the best efficacy belonged to imipenem with total 100% sensitivity, in which cipmfloxacin, amikacin and gentamicin were more effective against pseudomonas aeruginosa than others. Conclusion： Of all post - operative infection bacterias in orthopaedics clinics, the majority is Gram negative gemas, in which the dominant one is acinetobacter haemolyticus bauamnnii, and Gram positive germs infections is less than the former, in which the primacy is staphylococcus aureus. In terms of preventative post - operation antibiotics of orthopaedics, vancomycin, cipmfloxacin and compound sul- famethoxazole are preferred drugs against Gram positive germs, moreover, for the Gram negative germs, the preferable one are imipenem, cipmfloxacin, Amikacin, gentamicin respectively. Cipmfloxacin, as one with good sensitivity for both Gram positive and megative genus, could be the first choise in anti - post - operative infections in clinics.
出处
《华西医学》
CAS
2005年第1期61-62,共2页
West China Medical Journal
关键词
术后感染
病原菌
敏感度
Post- operative infection
Pathogens
Antibiotics sensitivity
作者简介
张俊（1933年-）．男，四川金堂人，主治医师，医学学士
通讯作者：屠重棋
