普通外科感染的菌种变迁及耐药性检测

目的 了解普通外科感染的菌种变迁和耐药情况。方法 分析1993年6月至1997年7月我院普通外科感染患者送检细菌培养阳性的557例。结果 分离革兰阴性（G^-)菌38种1045株（71.4%)，其中除最常见的大肠埃利希菌外，阴沟肠杆菌的检出率明显增高，列第3位，革兰阳性（G^ )菌8种418株（28.6%)，金黄色葡萄球菌和表皮葡萄球菌分别占第1、2位，粪肠球菌列第3位。阴沟肠杆菌和粪肠球菌系多重耐药菌种，细菌的药敏测定表明：G^-菌的敏感药物为氟喹诺酮类或第3代头孢菌素类药物；对G^ 菌抗菌活性较高的则是万古霉素、利福平等。结论 当前重视抗菌药物的合理应用对延缓菌种变迁和耐药性增长是有重要意义。

Investigation on the changing spectrum and antibiotic resistance of the pathogenic bacteria in general surgical infections

Objective　 To investigate the changing spectrum and antibiotic resistance of the pathogenic bacteria isolated from general surgical infections.　Methods　 The relevant bacterial materials from 557 patients with general surgical infection from June 1993 to July 1997 were investigated.　Results　 1 045 strains in 38 species of gram-negative bacteria and 418 strains (8 species) of gram-positive bacteria were isolated with a negative over positive rate of 71.4% to 28.6%. For gram-negatives, E coli was the most common, and enterobactor cloacae ranking the third was on a dramatic increase from isolations. Staphylococcus aureus and staphylococcus epidemidis were the most common gram-positive species followed by enterococcus faecalis. Enterobactor cloacae and enterococcus faecalis are multi-antibiotic resistant bacteria. The result of drug susceptibility test showed that gram-negative bacteria were sensitive to fluoroqinolones or third-generation cephalosporins while gram-positive bacteria were sensitive to vancomycin and rifampicin.　 Conclusion　 This study showed that the rational application of antibiotics is very important to suppress the spectrum changing and antibiotic resistance of the bacteria.