骨科病房患者常见临床分离菌株的耐药性检测

目的 了解骨科病房患者感染病原菌分布及耐药性,为临床合理选用抗菌药物提供依据.方法 采用纸片扩散法对临床分离菌株进行药敏试验,按CLSI 2008版判断结果.结果 73株分离病原菌中革兰阴性杆菌46株占63.0％,革兰阳性球菌22株占30.1％；革兰阴性菌中含假单胞菌属、克雷伯菌属等,革兰阳性菌中凝固酶阴性葡萄球菌、肠球菌属是主要菌种；大多数病原菌耐药性高,假单胞菌属对阿米卡星耐药率最低为5.6％,其次头孢他啶为11.1％,亚胺培南的耐药率为27.8％；凝固酶阴性葡萄球菌对万古霉素、阿米卡星100.0％敏感,对庆大霉素耐药率为37.5％,对其他抗菌药物的耐药率均＞62.4％.结论 条件致病菌成为骨科病房中主要的分离菌株,革兰阴性菌及凝固酶阴性葡萄球菌引起的感染耐药率高,应以药敏试验结果为依据合理选用抗菌药物.

Drug resistance of common pathogens isolated from patients in departments of orthopedics

OBJECTIVE To investigate the clinical distribution of pathogens causing infections in patients of department of orthopedics and the drug resistance so as to provide basis for clinical reasonable use of antibiotics.METHODS Kirby-Bauer disk diffusion method was applied for the drug susceptibility testing,the results were judged on the basis of CLSI 2008 version.RESULTS Of 73 strains of pathogens isolated,there were 46(63.0%) strains of gram-negative bacilli and 22(30.1%) strains of gram-positive cocci;Pseudomonas and Klebsiella were the most common gram-negative bacteria,and coagulase-negative Staphylococcus and Enterococcus were the most common gram-positive bacteria;the drug susceptibility testing demonstrated that the drug resistance of most of the pathogens was high,the resistance rate of Pseudomonas to amikacin was the lowest(5.6%),followed by ceftazidime(11.1%) and imipenem(27.8%);coagulase-negative Staphylococcus were 100.0% susceptible to amikacin and vancomycin,the resistance rate to gentamicin was 37.5%,the resistance rates to other antimicrobial agents were higher than 62.4 %.CONCLUSION The opportunistic pathogens are the major pathogens isolated from department of orthopedics,the drug resistance rates of gram-negative bacteria and coagulase-negative Staphylococcus are high,it is necessary to reasonably use antibiotics on the basis of drug susceptibility testing.