邢台地区骨科患者致病菌流行病学特征分析
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摘要
目的分析邢台地区骨科患者致病菌的流行病学特征,为临床骨科感染患者提供治疗依据。方法随机抽取2015年4月-2017年12月邢台地区骨科医院收治的骨科手术患者1 350例作为研究对象。其中Ⅰ类切口手术110例,Ⅱ类切口手术1 024例,Ⅲ类切口手术216例,采用纸片扩散法对致病菌进行药物敏感性试验。回顾性分析致病菌的流行病学情况及骨科手术部位感染的相关危险因素。结果Ⅰ类切口手术部位感染2例,Ⅱ类切口手术部位感染109例,Ⅲ类切口手术部位感染26例;凝固酶阴性葡萄球菌所占比例最高,其次是铜绿假单胞菌、阴沟肠杆菌、金黄色葡萄球菌;手术时间超过3 h、有吸烟史、预防用药不合理是导致骨科手术部位感染的相关危险因素。结论邢台地区骨科患者的致病菌以葡萄球菌、铜绿假单胞菌为主,临床上需重视可能导致感染的相关危险因素并注意预防、合理用药,降低感染风险。
Objective To analyze the epidemiological analysis of pathogens in orthopedic patients in Xingtai district,to provide treatment basis for patients with clinical orthopedic infection. Methods 1 350 patients with orthopaedic surgery in xingtai district orthopedic hospital from April 2015 to December 2017 were randomly selected. Among them,there were 110 cases of type Ⅰ incision surgery,1 024 cases of type Ⅱ incision surgery,216 cases of type Ⅲ surgical incision,and drug susceptibility test for pathogenic bacteria with paper diffusion method. The epidemiology of pathogenic bacteria and risk factors associated with orthopedic infections were retrospectively analyzed. Results Type Ⅰincision surgical site infection in 2 cases,typeⅡ incision surgical site infection in 109 cases,type Ⅲ incision surgical site infection in 26 cases; The proportion of coagulase negative staphylococcus was the highest,followed by pseudomonas aeruginosa,enterobacter cloacae and staphylococcus aureus;Surgery for more than 3 hours,smoking history,and unreasonable medication were risk factors for pathogen infection. Conclusion The pathogens of orthopedic patients in Xingtai district are mainly infected with staphylococcus aureus,pseudomonas aeruginosa. It is necessary to pay attention to the relevant risk factors that may lead to infection and pay attention to prevention and rational use of drugs and reduce the risk of infection.
Objective To analyze the epidemiological analysis of pathogens in orthopedic patients in Xingtai district,to provide treatment basis for patients with clinical orthopedic infection. Methods 1 350 patients with orthopaedic surgery in xingtai district orthopedic hospital from April 2015 to December 2017 were randomly selected. Among them,there were 110 cases of type Ⅰ incision surgery,1 024 cases of type Ⅱ incision surgery,216 cases of type Ⅲ surgical incision,and drug susceptibility test for pathogenic bacteria with paper diffusion method. The epidemiology of pathogenic bacteria and risk factors associated with orthopedic infections were retrospectively analyzed. Results Type Ⅰincision surgical site infection in 2 cases,typeⅡ incision surgical site infection in 109 cases,type Ⅲ incision surgical site infection in 26 cases; The proportion of coagulase negative staphylococcus was the highest,followed by pseudomonas aeruginosa,enterobacter cloacae and staphylococcus aureus;Surgery for more than 3 hours,smoking history,and unreasonable medication were risk factors for pathogen infection. Conclusion The pathogens of orthopedic patients in Xingtai district are mainly infected with staphylococcus aureus,pseudomonas aeruginosa. It is necessary to pay attention to the relevant risk factors that may lead to infection and pay attention to prevention and rational use of drugs and reduce the risk of infection.
引文
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[2]韩琼,任义军,胡锐,等.骨科患者术后院内感染病原菌及耐药性分析[J].现代预防医学,2015,42(22):4208-4210,4213.
[3]张德立,陈立福.骨科医院感染病原菌及药敏结果分析[J].中华医院感染学杂志,2001,11(2):147-148.DOI:10.3321/j.issn:1005-4529.2001.02.033.
[4]孙长贵,曾贤铭,成军.2005年CLSI/NCCLS文件M100-S15主要更新内容介绍[J].临床检验杂志,2005,23(5):382-386.DOI:10.3969/j.issn.1001-764X.2005.05.036.
[5]叶伟胜,张建国,周连兴,等.骨科内植物或关节置换后的细菌感染及抗生素敏感性[J].中国组织工程研究与临床康复,2008,12(44):8619-8622.DOI:10.3321/j.issn:1673-8225.2008.44.003.
[6]吴云刚,王忠仁,李志强,等.脊柱外科手术术后伤口感染致病菌分布及药物敏感性[J].脊柱外科杂志,2016,14(5):292-296.DOI:10.3969/j.issn.1672-2957.2016.05.008.
[7]张文明.骨科感染的细菌种类及细菌对抗菌药物敏感性的检测[J].中国实用医刊,2011,38(13):93-94.DOI:10.3760/cma.j.issn.1674-4756.2011.13.045.
[8]刘永良,刘秀坤,范志刚,等.骨外科感染病例细菌药物敏感性检测326例分析[J].航空航天医学杂志,2012,23(3):277-278.DOI:10.3969/j.issn.2095-1434.2012.03.009.
[9]吕豪,刘书明,杨华山,等.慢性骨髓炎患者感染病原菌分布及药物敏感性研究[J].中华医院感染学杂志,2016,26(22):5179-5181.DOI:10.11816/cn.ni.2016-161880.
[10]王彤,王立新,白雪,等.2014年骨科伤口感染患者病原菌分布及耐药性分析[J].国际检验医学杂志,2015,36(20):2989-2991.DOI:10.3969/j.issn.1673-4130.2015.20.029.
[11]戴滨,房德敏,王捷,等.骨科抗菌药物使用强度与细菌耐药率的变化趋势研究[J].中华医院感染学杂志,2012,22(15):3331-3333.