骨科I类切口手术患者金葡菌定植率及耐药性调查技术报告.docVIP

论文题目1：骨科I类切口手术患者金葡菌定植率及耐药性调查； 作者单位：河南省人民医院药学部；邮编450003；姓名：柴东燕； 通讯地址：河南省郑州市纬五路7号河南省人民医院药学部；联系电话 邮箱：chaidongyan2001@163.com； 正文： 骨科I类切口手术患者金葡菌定植率及耐药性调查 柴东燕1, 秦玉花1, 赵红卫1, 马冰2，赵成龙1, 王可3, 李军珂4，王培培5 （1 河南省人民医院药学部， 郑州 450003；2河南省人民医院检验科, 郑州 450003；3 信阳市中心医院药学部，信阳 464000；4 郑州市妇幼保健院 450012；5 驻马店市中心医院药剂科 463000） 摘要:目的　了解骨科I类切口手术患者皮肤和鼻腔金葡菌（SA）定植率及耐药性。方法　术前用无菌注射用水湿润的棉签分别在患者切口皮肤及鼻前庭取样,培养，对鉴定为金黄色葡萄的菌株进行药敏监测。结果　切口皮肤未检出金葡菌，鼻腔金黄色葡萄球菌的定植率为6%,分离菌株对头孢唑林、庆大霉素、环丙沙星、利福平、万古霉素等均敏感性较好，对青霉素、红霉素、克林霉素耐药率高，未检出耐甲氧西林的金黄色葡萄球菌（MRSA）。结论　金葡菌在鼻腔的定植率较高,但MRSA定植率低,检出的菌株对青霉素和红霉素以外的多数抗菌药物敏感。 关键词:I类切口;金黄色葡萄球菌;定植率;耐药性 Investigation on the colonization rate and drug resistance status of Staphylococcus aureus in Orthopedic surgery with type I incision ABSTRACT: Objective To evaluate the colonization rate and drug resistance status of Staphylococcus aureus from Skin of operative incision and nasal vestibule in Orthopedic surgery with type I incision .Methods The specimen was taken by swabs from the skin of operative incision and nasal vestibule before operation , then was tested and identified SA, Susceptibilities were confirmed. Results The specimens from the skin were not identified SA，the nasal colonization rate of SA was 6%. The susceptible rates of isolates to cefazolin, gentamicin,ciprofloxacin, rifampin and vancomycin were higher, and the rates to penicillin, erythromycin and clindamycin were lower. MRSA was not detected. Conclusion The nasal colonization rate of SA was high . The isolates were susceptible to most antimicrobial agents except penicillin ，erythromycin and clindamycin. KEY WORDS Type I incision;Staphylococcus aureus; Colonization rate; Drug resistance 随着抗菌药物的广泛应用，细菌耐药水平日趋增高，严重威胁人类健康，人们对耐药菌的关注度日益提高。在美国大约有30%的切口感染菌为金葡[1]，定植菌被认为是一种术后感染潜在的污染源[2-3]。做为成人骨髓炎最常见的病原菌--金黄色葡萄球菌，国外的研究[4-5]表明：关节置换术术前患者皮肤或鼻腔金葡菌定植率高达20-30%，而国内对骨科术前皮肤和鼻腔定植菌的研究较少。本研究的目的为调查骨科I类切口手术患者术前皮肤、鼻腔金葡菌定植率及耐药情况，同时，拟将切口感染时切口分泌物和血培养结果为金葡菌的菌种与术前采样分离的金葡菌进行同源性分析，了解定植与术后感染的相关性。 1 调查对象与方法 1.1 入选标准 骨科I类切口手术的患者，经患者或