创伤后慢性骨髓炎致病菌分布特点及耐药性分析

摘要

Objective:To analyze the distribution of pathogenic bacteria and the characteristic of tolerance of post-traumatic chronic osteomyelitis,therefore to provide the evidence for clinical rational application of antibacterials. Methods:Clinical data of 105 patients were analyzed retrospectively,to count the results of drug sensitive test and microorganism training of the infected tissue.Results:All 23 species and 112 strains of pathogenic bacteria were ob-tained from 105 patients. Among them, Gram-positive bacteria accounted for 47.32%, there were 19 strains of Staphylococcus aureus(16.96%),11 strains of Staphylococcus epidermidis(9.82%),nine strains of Methicillin-resis-tant Staphylococcus aureus(MRSA)(8.04%)and six strains of Enterococcus faecalis(5.36%),gram positive bacteria presented the highest susceptibility to vancomycin highly;Gram-negative bacteria held 52.68%,the bacteria in high-er detection rates were 15 strains of Pseudomonas aeruginosa(13.39%),13 strains of Aerobacter cloacae(11.61%), ten strains of Escherichia coli (8.93%)and five strains of Klebsiella pneumoniae (4.46%),gram-negative bacteria showed the highest susceptibility to meropenem and imipenem. Conclusion: Staphylococcus aureus and Pseu-domonas aeruginosa are the two kinds of bacteria in the higher ratio among the pathogenic bacteria of posttraumatic chronic osteomyelitis, vancomycin and Meropenem are highly sensitive antibiotics to Gram positive and negative bacteria respectively.%目的:分析创伤后慢性骨髓炎致病菌分布和耐药性特点,为临床合理应用抗生素提供依据.方法:回顾性分析105例创伤后骨髓炎患者资料,统计感染组织微生物培养和药敏试验结果.结果:105例患者共培养出致病菌23种,112株.其中革兰阳性菌占47.32%,检出率较高的有金黄色葡萄球菌19株(16.96%),表皮葡萄球菌11株(9.82%),耐甲氧西林金黄色葡萄球菌9株(8.04%),粪肠球菌6株(5.36%),革兰阳性菌对万古霉素敏感性最高.革兰阴性菌占52.68%,检出率较高的有铜绿假单胞菌15株(13.39%),阴沟肠杆菌13株(11.61%),大肠埃希菌10株(8.93%),肺炎克雷伯菌5株(4.46%),革兰阴性细菌对美罗培南和亚胺培南敏感性最高.结论:创伤后慢性骨髓炎致病菌中,金黄色葡萄球菌和铜绿假单胞菌是占比最高的两种细菌,万古霉素和美罗培南分别是针对革兰阳性和阴性菌的高敏感抗生素.