口腔术后感染伤口分泌物中的病原菌分布及药敏分析

目的 观察口腔术后感染伤口分泌物中的病原菌分布及对抗菌药物的耐药性,为临床工作提供支持.方法 收集68例口腔术后感染的患者,留取伤口分泌物,进行细菌培养及药物敏感试验.结果 68例伤口分泌物中分离出病原菌97株,排在前4位的为金黄色葡萄球菌(26.80％)、凝固酶阴性葡萄球菌(20.62％)、大肠埃希菌(18.56％)、肺炎克雷伯菌(13.40％)；对切口感染金黄色葡萄球菌敏感性较高的抗菌药物依次为万古霉素(100.00％)、头孢曲松(88.46％)、庆大霉素(65.38％),对凝固酶阴性葡萄球菌敏感性较高的抗菌药物依次为万古霉素(100.00％)、阿米卡星(70.00％)、庆大霉素(55.00％),对大肠埃希菌敏感性较高的抗菌药物依次为亚胺培南(100.00％)、头孢哌酮(83.33％)、妥布霉素(61.11％),对肺炎克雷伯菌敏感性较高的抗菌药物依次为亚胺培南(100.00％)、庆大霉素(84.62％)、妥布霉素(76.92％).结论 口腔术中及术后应严格无菌操作,严防术后患者的伤口感染；对切口感染的患者,及时进行分泌物细菌培养及耐药性的检测,对指导临床合理用药具有重要意义.

Distribution and drug sensitivity of pathogenic bacteria from wound secretions after oral operation

OBJECTIVE To observe the distribution of pathogenic bacteria from wound secretions after oral operation and their drug resistance,so as to support the clinical work.METHODS A total of 68 patients with infections after oral operation were enrolled in the study,the secretions were sampled for bacterial culture and drug susceptibility testing.RESULTS Totally 97 strains of pathogen bacteria were isolated from wound secretions of 68 patients.Staphylococcus aureus(26.80%),coagulase-negative Staphylococci(20.62%),Escherichia coli(18.56%) and Klebsiella pneumonia(13.40%) were the top 4 pathogenic bacteria.The drug susceptibility rates of Staphylococcus aureus causing incision infections were as follows:vancomycin(100.00%),ceftriaxone(88.46%),and gentamicin(65.38%);the drug susceptibility rates of coagulase-negative Staphylococci were as follows:vancomycin(100.00%),amikacin(70.00%) and gentamicin(55.00%);the drug susceptibility rates of Escherichia coli were as follows :imipenem(100.00%),cefoperazone(83.33%) and tobramycin(61.11%);the drug susceptibility rates of K.pneumonia were as follows:imipenem(100.00%),gentamicin(84.62%),and tobramycin(76.92%).CONCLUSION Strict aseptic operation is important in oral surgery to prevent incision infections.For the patients with incision infection,timely bacterial culture for secretions and test for drug resistance has great significance for clinical reasonable use of antibiotics.