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目的研究骨科住院患者感染病原菌种类及其耐药性,为临床合理使用抗菌药物提供参考。方法采用细菌分离培养和药敏试验方法,对某医院骨科病房1 460份送检标本进行细菌鉴定及药敏试验。结果从1 460份标本中共检出病原菌860株,检出率58.9%。在检出的病原菌中,革兰阳性球菌占66.0%,其中金黄色葡萄球菌,表皮葡萄球菌、腐生葡萄球菌居前3位;革兰阴性杆菌占30.0%,主要包括铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌等;真菌占4.0%。骨科临床分离革兰阳性球菌对万古霉素和替考拉宁敏感,革兰阴性杆菌对亚胺培南敏感。结论骨科住院患者感染病原菌主要是革兰阳性球菌,临床分离的病原菌对常用抗菌药物普遍耐药,根据药敏试验结果选择抗菌药物是有效控制感染的关键。
Objective To study the types and drug resistance of pathogenic bacteria in orthopedic inpatients and provide references for the rational use of antibacterials in clinic. Methods Bacteria isolation and culture and drug susceptibility testing methods were used to conduct bacterial identification and drug susceptibility testing on 1 460 samples from an orthopedic ward in a hospital. Results A total of 860 pathogens were detected from 1 460 samples, the detection rate was 58.9%. Among the detected pathogens, Gram-positive cocci accounted for 66.0%, of which Staphylococcus aureus, Staphylococcus epidermidis and Staphylococcus saprophyticus ranked the top three; Gram-negative bacilli accounted for 30.0%, mainly including Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii; fungi accounted for 4.0%. Gram-positive cocci isolated from orthopedics were sensitive to vancomycin and teicoplanin, and Gram-negative bacilli were sensitive to imipenem. Conclusion The pathogenic bacteria in hospitalized orthopedic patients are mainly Gram-positive cocci. The clinically isolated pathogens are generally resistant to the commonly used antibacterials. The key to effective infection control is to select antibacterials according to the results of drug susceptibility test.