本文選題：上肢　切入點：骨折　出處：《中華醫(yī)院感染學雜志》2017年09期

【摘要】：目的篩查上肢骨折患者術后傷口感染細菌種類分布特點、分析藥敏結果,旨在降低耐藥菌株產(chǎn)生、控制感染,為臨床合理選取抗菌藥物提供細菌學參考依據(jù)。方法選取2014-2016年372例上肢骨折術后傷口感染患者,比較2014、2015年和2016年傷口細菌種類及分布、主要革蘭陽性菌、革蘭陰性菌藥敏試驗結果。結果檢出病原菌370株,3年內(nèi)細菌種類及分布比較,差異無統(tǒng)計學意義;每個年度內(nèi),金黃色葡萄球菌百分比高于其他陽性菌株檢出率,銅綠假單胞菌百分比高于其他陰性菌株檢出率,差異有統(tǒng)計學意義(P0.05);2015、2016年與2014年比較,金黃色葡萄球菌對氨芐西林、氧氟沙星耐藥率,表皮葡萄球菌對氨芐西林、莫西沙星耐藥率,差異有統(tǒng)計學意義(P0.05);2014年,金黃色葡萄球菌、表皮葡萄球菌對青霉素耐藥率高于本年度其他類別抗菌藥物,2015、2016年,對青霉素和氨芐西林耐藥率高于其他抗菌藥物,差異有統(tǒng)計學意義(P0.05);2015年鮑氏不動桿菌對亞胺培南、美羅培南、氧氟沙星耐藥率與2014年比較,差異有統(tǒng)計學意義(P0.05);2016年與2015年比較,鮑氏不動桿菌對頭孢哌酮/舒巴坦耐藥率,差異有統(tǒng)計學意義(P0.05);且各年度內(nèi)銅綠假單胞菌對氨芐西林耐藥率與其他抗菌藥物比較,差異有統(tǒng)計學意義(P0.05),鮑氏不動桿菌對頭孢曲松、頭孢他啶、頭孢吡肟、慶大霉素、阿米卡星和環(huán)丙沙星耐藥率,差異有統(tǒng)計學意義(P0.05)。結論加強上肢骨折患者術后傷口感染觀察、及時篩查創(chuàng)面病菌種類分布信息,根據(jù)藥敏結果選取合理抗菌藥物,有助于控制感染、促進傷口愈合。
[Abstract]:Objective to screen the distribution of bacteria of wound infection in patients with upper limb fracture after operation and analyze the results of drug sensitivity in order to reduce the production of drug-resistant strains and control infection, and to provide the bacteriological reference for the rational selection of antimicrobial agents in clinic.Methods 372 patients with wound infection after upper limb fracture from 2014 to 2016 were selected to compare the types and distribution of wound bacteria in 2014, 2015 and 2016, and the results of drug sensitivity test of major Gram-positive bacteria and Gram-negative bacteria.Results 370 strains of pathogenic bacteria were detected. There was no significant difference in the species and distribution of bacteria within 3 years, and the percentage of Staphylococcus aureus was higher than that of other positive strains in each year.The resistance rate of moxifloxacin was statistically significant (P 0.05). In 2014, the resistance of Staphylococcus aureus and Staphylococcus epidermidis to penicillin was higher than that of other antimicrobial agents of this year. In 2016, the resistance rate to penicillin and ampicillin was higher than that of other antibiotics.The difference was statistically significant (P 0.05); the resistance rate of Acinetobacter baumannii to imipenem, meropenem and ofloxacin in 2015 was significantly higher than that in 2014, and the resistance rate of Acinetobacter baumannii to cefoperazone / sulbactam was significantly higher in 2016 than in 2015.There were significant differences in the resistance of Pseudomonas aeruginosa to ampicillin in each year compared with other antimicrobial agents (P 0.05), Acinetobacter baumannii to ceftriaxone, ceftazidime, cefepime, gentamicin.The drug resistance rate of amikacin and ciprofloxacin was significantly higher than that of ciprofloxacin.Conclusion it is helpful to control infection and promote wound healing by strengthening observation of wound infection in patients with upper limb fracture, screening distribution information of bacteria in time, and selecting reasonable antibiotics according to drug sensitivity results.
【作者單位】： 河南省洛陽正骨醫(yī)院河南省骨科醫(yī)院膝部損傷二科上肢損傷二科;河南省洛陽正骨醫(yī)院河南省骨科醫(yī)院脊柱外科;河南省洛陽正骨醫(yī)院河南省骨科醫(yī)院髖部損傷四科;河南省洛陽正骨醫(yī)院河南省骨科醫(yī)院ICU;
【分類號】：R687.3

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