ObjectiveTo realize the detection of pathogens and antimicrobial resistance of pathogens isolated from wound secretion in patients with open fractures, so as to guide clinical treatment.  Methods1 472 patients with open fractures from May 2012 to July 2013 were selected from a hospital, pathogens from wound secretions before and after debridement were identified and performed antimicrobial susceptibility testing. ResultsBefore debridement, 1 246 of 1 472 patients (84.65%) were isolated 2 246 bacterial strains, 824 (55.98%) of patients were isolated at least 2 kinds of bacteria. Eight  hours after  debridement, 201 pathogenic bacteria were isolated from 195 patients  (13.25%).  The more serious of  Gustilo type, the higher the positive rate of bacterial culture. Positive rate of wound culture were all ＞50% in patients of  all Gustilo types before debridement；positive rate were all ＜5% in patients of  type I,  Ⅱ and  ⅢA, but type ⅢB and  ⅢC were still high after debridement. Staphylococcus aureus and Staphylococcus epidermidis were sensitive to vancomycin， the resistant rates to furantoin were <5%, the resistant rates to penicillin G and erythromycin were all >75%. Acinetobacter baumannii had higher resistance to multiple antimicrobial agents, to cefoperazone / sulbactam was 20%; Pseudomonas aeruginosa to imipenem was 10.80%, sensitivity to cefoperazone / sulbactam,cefepime and ceftazidime  were all higher. ConclusionFor patients with open fractures, timely debridement can reduce wound pathogen, antimicrobial susceptibility testing result is helpful for guiding rational antimicrobial use.

open fracture; wound; debridement; bacteria; pathogen; healthcareassociated infection