创伤病区五年内创口分泌物病原菌分布和耐药性分析.docVIP

创伤病区五年内创口分泌物病原菌分布和耐药性分析 　　[摘要] 目的 了解创伤病区五年内创口分泌物标本的病原菌分布和耐药情况，为临床合理用药提供依据。 方法 分析2010～2014年创伤病区送检的747株病原菌。 结果 747株病原菌中，革兰阳性菌343株（45.9%），革兰阴性菌400株（53.5%），白假丝酵母真菌4株（0.6%）。检出的主要革兰阳性菌为金黄色葡萄球菌，共132株（17.7%）；主要革兰阴性菌为大肠埃希菌，共123株（16.5%）。耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）检出率分别为47.9%和82.7%，未检出对糖肽类中介或耐药的葡萄球菌和肠球菌；大肠埃希菌的ESBLs检出率为58.8%，未检出对亚胺培南耐药的菌株；检出多重耐药的铜绿假单胞菌13株，鲍曼不动杆菌27株。 结论 创口感染的菌株类型较多，以革兰阴性菌为主，但金黄色葡萄球菌仍为感染的首要细菌；病原菌多重耐药菌较常见，定期进行病原菌分布和耐药情况分析，有助于了解其耐药性变迁，为临床合理用药提供依据。 　　[关键词] 创口；分泌物；病原菌；耐药性 　　[中图分类号] R446.5 [文献标识码] A [文章编号] 1673-9701（2015）25-0013-04 　　Distribution and drug resistance of pathogenic bacteria from wound secretion of trauma ward in five years 　　WANG Wei1 JIANG Weiyan2 HE Qianggui1 FANG Jun1 TAO Lijun1 XU Hongbo1 CHENG Shuibing1 BAO Qiyu3 　　1.Trauma Surgery，the First Affiliated Hospital of Wenzhou Medical University， Wenzhou 325000， China； 2.Center of Medical Laboratory， the Second Affiliated Hospital of Wenzhou Medical University， Wenzhou 325000， China； 3.Institute of Biomedical Informatics， Wenzhou Medical University， Wenzhou 325035， China 　　[Abstract] Objective To investigate the distribution and drug resistance of pathogenic bacteria isolated from wound secretion specimens in trauma ward in the past 5 years， and to provide a reasonable basis for application of antimicrobial agents. Methods 747 strains of pathogenic bacteria of trauma ward from 2010 to 2014 were analyzed. Results There were 343 gram-positive bacteria （45.9%）， 400 of gram-negative bacteria （53.5%） and 4 of fungus （0.6%）. The main gram-positive and gram-negative bacteria were S. aureus and E. coli， accounting for 17.7% and 16.5%. MRSA and MRCNS were 47.9% and 82.7%， all the Staphylocuccus and Enterococus were sensitive to glycopeptide antibiotics. ESBLs of E. coli was 58.8%， and there was no imipenem-resistant strain. The multiple drug resistance strains of P. aeruginosa and A.baumannii were 13 and 27. Conclusion Many bacteria can course wound infection. The main bacteria are gram-nega