伤口感染常见病原菌分布及耐药监测

目的 调查本院伤口感染病原菌的分布及主要病原菌对常用抗生素的耐药情况.方法 对2011~2012年我院创伤患者伤口分泌物分离的病原菌进行鉴定和药敏试验,应用WHONET 5.6软件进行统计分析.结果 ①分离率最高的病原菌依次为：金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌;②药敏结果显示：葡萄球菌中耐甲氧西林金黄色葡萄球菌（MRSA）检出率为21.5%;屎肠球菌对万古霉素的耐药率为5.9%,粪肠球菌对万古霉素均敏感;肠杆菌科细菌产ESBLs大肠埃希菌和肺炎克雷伯菌的检出率分别为60%和35.4%,没有检出耐亚胺培南的大肠埃希菌及肺炎克雷伯菌;鲍曼不动杆菌对常用抗菌药物抗生素耐药率〉50.0%;铜绿假单胞菌对常用的有抗假单胞菌活性的药物的耐药率〈20%.结论 伤口感染主要致病菌分别为金黄色葡萄球菌·大肠埃希菌和肺炎克雷伯菌,细菌耐药现象较严重,经验性选择抗生素应依据本院细菌耐药监测结果.

Analyzing the drug resistance and distribution ofwound infections inpatients

Objective To investigate the bacterial distribution and antibiotic resistance of wound infections in Sichuan provincial people~ hospital during 2011- 2012. Methods The bacteria strains isolated from clinics were collected. Identification and drug susceptibility test were performed by VITEK2-compact automatic analysis system. Results A total of 1049 isolates were isolated from wound infections, including 554 Gram-negative strains and 473Gram-positive strains. The top three pathogens were Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae. The detection rates of Methicillin-resistant Staphylococcus au- reus （MRSA） were 21.5% ; The resistant rates of Enterococcus faecium to vancomycin （VRE） were 5.9%. ESBLs - producing strains accounted for 60% in Escherichia coli and 35.4% in Klebsiella pneumoniae. Acinetobacter baumannii had higher resistant rates to almost all the antibiotics than Pseudomonas aeruginosa. Conclusion Staphylococcus spp, Escherichia coli and Acinetobacter baumannii were predominant pathogens in wound infections. The majority of the pathogens are multi-resistance strains, so the resistance of pathogens should be monitored to provide practical guidance of rational selection of antibiotics for clini- cians.