汶川地震灾害后创伤患者感染伤口菌群分析
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摘要
目的了解汶川地震灾害后受伤患者感染伤口的常见致病菌及部分抗生素耐药率。方法从2008年5～7月收治的地震灾害后伤口感染的患者中,经过提取伤口分泌物并送培养及药敏试验,对其细菌学特点、药物耐药性进行总结分析。结果在送检的193份样品中,156份检出了病原菌,检出率为80.83%:革兰阴性杆菌81株,占51.92%;革兰阳性球菌66株,占42.31%,厌氧菌9株,占5.77%。革兰阴性杆菌对美罗培南、舒普深的耐药率较低;革兰阳性球菌对万古霉素、米诺环素等抗生素的耐药率较低。革兰阳性球菌的总体耐药率较高。结论地震灾害等自然灾害后受伤患者感染伤口在及时进行清创引流的同时,应结合培养及药敏试验的结果,根据细菌学特点和对抗生素的耐药率合理选用抗生素。
Objective To study the frequent pathogenic bacteria and antibiotics resistant rate of infected wound in the trauma patients after earthquake disaster in Wenchuan of China.Methods The wound secretion of infected wound from the trauma patients send to our hospital after earthquake disaster during May to July 2008,was extracted to culture and drug sensitive test.The results of character of bacteriology and drug tolerance were analyzed.Results One hundred and fifty-six examples were cultured bacteria from all the 193 examples,the positive rate of cultivation was 80.83%.Gram-negative bacili were 81(51.92%) strains,Gram-positive cocci were 66(42.31%) strains and anaerobic bacteria were 9(5.77%) strains.The resistant rate of antibiotics of Gram-positive cocci was high,while the Gram-positive cocci were susceptible to vancomycin and minocycline,and the Gram-negative bacili were susceptible to meropenem and sulperazon.Conclusion It is important to reasonably adopt antibiotics according to the character of bacteriology,drug tolerance,the results of culture and drug sensitive test while to promptly debride and drain infected wound in the trauma patients after earthquake disaster.
Objective To study the frequent pathogenic bacteria and antibiotics resistant rate of infected wound in the trauma patients after earthquake disaster in Wenchuan of China.Methods The wound secretion of infected wound from the trauma patients send to our hospital after earthquake disaster during May to July 2008,was extracted to culture and drug sensitive test.The results of character of bacteriology and drug tolerance were analyzed.Results One hundred and fifty-six examples were cultured bacteria from all the 193 examples,the positive rate of cultivation was 80.83%.Gram-negative bacili were 81(51.92%) strains,Gram-positive cocci were 66(42.31%) strains and anaerobic bacteria were 9(5.77%) strains.The resistant rate of antibiotics of Gram-positive cocci was high,while the Gram-positive cocci were susceptible to vancomycin and minocycline,and the Gram-negative bacili were susceptible to meropenem and sulperazon.Conclusion It is important to reasonably adopt antibiotics according to the character of bacteriology,drug tolerance,the results of culture and drug sensitive test while to promptly debride and drain infected wound in the trauma patients after earthquake disaster.
引文
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[2]庞君容.术后切口感染与抗生素耐药性分析[J].西部医学,2007,19(1):85.
[3]蔡俊伟.外科切口感染病原菌的耐药性分析[J].中国热带医学,2006,6(6):1053.
[4]丁波,刘家瑞.外科感染常见病原菌的分离鉴定及耐药性分析[J].西部医学,2005,17(4):312.
[5]张衡,张敏.骨科手术切口感染细菌分布和耐药性的研究[J].齐鲁医学检验,2005,16(1):46.
[6]张金艳,单保恩,王明霞.2年医院感染的细菌分布及药敏检测分析[J].中华医院感染学杂志,2002,12(6):473.
[7]张梅,兰平,过孝静,等.几种医院感染细菌耐药性的变化[J].中华医院感染学杂志,2000,10(4):302.
[8]李华.42株表皮葡萄球菌耐药性分析[J].重庆医学,2008,37(16):1795.
[9]刘锡光,何晓青,洪秀华,等.现代诊断微生物学[M].北京:人民卫生出版社,2002:1.
[10]李宏光,李淑芬.临床抗生素应用与细菌耐药性分析[J].中华医院感染学杂志,2001,11(2):130.
[11]Porretta A,Giuliani L,Vegni FE,et al.Prevalence and patterns of antibiotic prescribing in Italian hospitals[J].Infection,2003,31(2):16.
[12]梦溪.抗药性细菌构成严重威胁[J].中国医学论坛报,1997,23(18):4.
[13]张玲燕,赵跃,赵海燕,等.5.12汶川大地震后医院感染控制应急模式探讨[J].重庆医学,2008,37(16):1767.
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