某部队医院官兵创伤感染的病原菌分布及耐药性
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徐忠玉

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R63R969.3

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南京军区面上项目南京军区医学科技创新课题(14MS086)


Distribution and antimicrobial resistance of pathogens causing wound infection in army officers and soldiers in a military hospital
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    摘要:

    目的了解部队训练伤患者伤口感染病原菌分布及耐药情况,为临床军医用药提供参考依据。方法对某院2014年1月—2015年6月收治的部队伤患者伤口分泌物进行细菌培养及药敏分析。结果临床送检部队伤病员伤口分泌物标本1 029份,分离病原菌647株,检出率为62.88%,居前6位的病原菌为金黄色葡萄球菌(29.99%,194株)、大肠埃希菌(19.32%,125株)、铜绿假单胞菌(19.17%,124株)、肠球菌属(13.60%,88株)、肺炎克雷伯菌(7.73%,50株)和鲍曼不动杆菌(5.87%,38株)。金黄色葡萄球菌和肠球菌属细菌对万古霉素、利奈唑胺、达托霉素均具有较高的敏感性(耐药率均≤3.41%),其中金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)检出率达44.33%,肠球菌属中耐万古霉素肠球菌(VRE)的检出率为2.27%。大肠埃希菌和肺炎克雷伯菌对哌拉西林/他唑巴坦保持较高的敏感性(耐药率为1.60%和0)。除鲍曼不动杆菌外,革兰阴性菌对碳青霉烯类抗生素耐药率均较低(耐药率均≤4.00%)。结论临床军医应根据药敏结果选择合适的抗菌药物,降低战创伤感染的伤残率,为伤员救治提供临床支持。

    Abstract:

    ObjectiveTo understand the distribution and antimicrobial resistance of pathogens causing wound infection in army officers and soldiers following military training injury, and provide reference for antimicrobial use in clinical antiinfection treatment. MethodsWound secretion from injured army patients who were admitted to a military hospital between January 2014 and June 2015 was performed bacterial culture and antimicrobial susceptibility testing. Results647 pathogenic bacteria strains were isolated from 1 029 wound secretion specimens , isolation rate was 62.88%, the top 6 isolated bacteria were Staphylococcus aureus(S. aureus, 29.99%, n=194), Escherichia coli(E. coli, 19.32%,n=125), Pseudomonas aeruginosa(19.17%,n=124),Enterococcus spp.(13.60%,n=88),Klebsiella pneumoniae(K. pneumoniae, 7.73%,n=50), and  Acinetobacter baumannii (A. baumannii, 5.87%,n=38). S. aureus and Enterococcus spp. had high susceptibility to vancomycin, linezolid , and daptomycin (resistance rates ≤3.41%), 44.33% of S. aureus were methicillinresistant, 2.27% of Enterococcus spp. were vancomycinresistant . E.coli and K. pneumoniae had high susceptibility rates to piperacillin/ tazobactam (resistance rates were 1.60% and 0 respectively), except A. baumannii, resistance rates of gramnegative bacteria to carbapenems were all low (resistance rates ≤4.00%). ConclusionMilitary clinicians should select appropriate antimicrobial agents according to antimicrobial susceptibility testing results, reduce the disability rate due to infection in trauma patients, and provide clinical support for the treatment of the wounded.

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徐忠玉,郭健莲,肖斌龙,等.某部队医院官兵创伤感染的病原菌分布及耐药性[J]. 中国感染控制杂志,2016,15(10):726-729. DOI:10.3969/j. issn.1671-9638.2016.10.002.
XU Zhongyu, GUO Jianlian, XIAO Binlong, et al. Distribution and antimicrobial resistance of pathogens causing wound infection in army officers and soldiers in a military hospital[J]. Chin J Infect Control, 2016,15(10):726-729. DOI:10.3969/j. issn.1671-9638.2016.10.002.

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  • 收稿日期:2016-01-08
  • 最后修改日期:2016-03-22
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  • 在线发布日期: 2016-10-26
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