濒海战创伤动物模型腹腔感染细菌学特点及药敏试验研究

摘要

目的 探讨濒海实地海水中动物模型腹部火器伤后腹腔感染的细菌学特点及其药敏试验研究.方法 将小型猪分为海水中腹部火器伤组(n=8)和陆地腹部火器伤组(n=8).海水中腹部火器伤组浸泡于海水中,在距离10 m处步枪射击左麦氏点处,继续浸泡30 min,陆地腹部火器伤组固定于陆地支架上,相同方法射击后于陆地观察30 min;之后两组行剖腹探查术,术中取腹腔液5 ml行细菌检测.细菌鉴定分析仪进行细菌学鉴定,抗菌药物敏感试验使用K-B 纸片琼脂扩散法.同时采集8份海水进行细菌鉴定.结果 两组共同检测出表皮葡萄球菌、奇异变形杆菌、大肠埃希菌等内源性肠道菌群,其中海水中腹部火器伤组检测出特有的副溶血弧菌(4%)、溶藻弧菌(8%).细菌药敏实验结果显示,对革兰阴性菌敏感率大于70%的抗菌药物包括亚胺培南、阿莫西林/克拉维酸、替卡西林/克拉维酸妥布霉素等.对革兰阳性菌敏感率大于70%的抗菌药物包括环丙沙星、达托霉素、呋喃妥因等.结论 濒海实地海水中腹部火器伤后腹腔感染为内源性肠道菌群、皮肤表面菌群和海水中特有弧菌的混合感染,故提倡早期联合使用广谱抗生素控制感染.%Objective To investigate the bacteriological characteristics and drug sensitivity test for abdominal infection of animal model after abdominal firearm injury in littoral seawater.Methods Mini-pigs were randomly divided into two groups, the group of abdominal firearm injury in littoral seawater(n=8) and the group on land (n=8).The pigs of abdominal firearm injury in littoral seawater group were soaked in sea water, and were shot from a distance of 10 m, hitting the left mcburney point, finally immersed into seawater for 30 min. Pigs in another group were fixed on fixator on land and were shot in the same way, finally observed on land for 30 min. The animals in two groups underwent exploratory laparotomy. 5 ml peritoneal fluid was taken by disposable sterilized syringe for bacterial and antimicrobial susceptibility analysis. Bacteriology analyzer was applied in bacteria identification and K-B paper agar diffusion method was used in antibacterial drug sensitive test. Meanwhile 8 samples of littoral seawater were collected and cultured to identify bacterial species. Results Both two groups were detected to have epidermis staphylococcus, singular proteus, E.coli and other endogenous gut bacterial flora, and abdominal firearm injury in littoral seawater group was particularly detected to carry with vibrio parahaemolyticus (4%), vibrio alginolyticus (8%). The results of drug susceptibility test showed that antimicrobial drugs, including imipenem, amoxicillin/clavulanic acid, ticarcillin amoxicillin/clavulanate clavulanic acid tobramycin, etc., of which the gram-negative bacteria sensitive rate was more than 70%, and antimicrobial drugs including ciprofloxacin, dato mold element, nitrofurantoin, etc., of which gram-positive bacteria sensitive rate was more than 70%.Conclusions Abdominal infection after abdominal firearm injury in littoral seawater is caused by the mixed infection for endogenous gut bacteria, flora on the skin surface and unique vibrio in seawater, therefore early joint use of broad-spectrum antibiotics is advocated to control infection.