探讨骨科无菌手术切口感染的病原菌类型、耐药性及感染危险因素

王炜1，邢秀峰1，樊春海1 ，申志军1，张志斌2

[1.榆阳区人民医院（榆林市儿童医院）骨科，陕西 榆林，719000；2. 榆林市第一医院胸心外科，陕西 榆林，719000]

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摘要：

目的 分析临床骨科患者手术后引起切口感染的病原菌分布情况、各类病原菌的耐药性与切口感染的相关影响因素。 方法 随机选取在我院骨科实施相关手术治疗的患者500 例，搜集所有患者的相关资料，总结引发切口感染的病原菌分布情 况、各类病原菌的耐药性与相关影响因素。结果 500 例患者中，切口感染共发生19 例，占比为3.80%（19/500）。其中，革兰氏 阳性菌感染7 例（36.84%），革兰氏阴性菌感染12 例（63.16%）。亚胺培南对大肠埃希菌、铜绿假单胞菌及鲍氏不动杆菌没有耐药 性。利福平和万古霉素对金黄色葡萄球菌及表皮葡萄球菌没有耐药性。年龄、切口状况、是否存在糖尿病、住院时间及手术时间 均会影响术后切口感染的发生（P<0.05）。结论 临床骨科患者手术后引起切口感染的病原菌主要包含金黄色葡萄球菌与大肠埃 希菌，在临床用药抗感染时应选取各病原菌不耐受的药物，而在治疗期间应评估患者的切口感染概率，实施早期预防。

关键词：切口感染；金黄色葡萄球菌；影响因素；耐药状况；骨科

中图分类号：R687文献标志码：A文章编号：2096-1413(2017)35-0068-02

Pathogenic bacteria types, drug resistance and risk factors of surgical incision infection investigation

in osteopathic department
WANG Wei 1, XING Xiu-feng 1, FAN Chun-hai 1, SHEN Zhi-jun 1, ZHANG Zhi-bin 2
[1. Orthopedics Department, People``s Hospital of Yuyang District ( Children``s Hospital in Yulin ), Yulin 719000;
2. Cardiothoracic Surgery Department, the First Hospital of Yulin, Yulin 719000, China]

ABSTRACT: Objective To analyze the pathogenic bacteria types, drug resistance of pathogens and the related factors in patients with surgical incision infection in the orthopedics department. Methods A total of 500 patients with surgical treatment in our hospital were randomly selected in the orthopedics department, and the relevant data of all patients were collected and the pathogenic bacteria of wound infection, drug resistance and the related factors were summarized. Results Of the 500 patients, there were 19 cases of incision infection, accounting for 3.80% (19/500), among them, Gram-positive bacteria were in 7 cases (36.84%) and Gram-negative bacteria were in 12 cases (63.16%). Imipenem had no resistance to Escherichia coli, Pseudomonas aeruginosa and Acinetobacter baumannii. Rifampicin and vancomycin had no resistance to Staphylococcus aureus and Staphylococcus epidermidis. Age, incision status, presence or absence of diabetes, length of hospital stay and operation time can affected the incisional wound infection (P<0.05). Conclusion The pathogenic bacteria caused incision infection on patients after surgery in the orthopedics department were mainly including Staphylococcus aureus and Escherichia coli, and the anti-infective drugs of the pathogen of intolerance should be selected and used in the clinic. The incision infection``s probability of patients should be assessed during the treatment , and early prevention should be taken.
KEYWORDS: incision infection; Staphylococcus aureus; influencing factors; drug resistance; orthopedics department

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