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目的 探讨伤口分泌物常见病原菌及其对常用抗生素的耐药情况,为临床伤口感染的抗生素选择提供科学依据. 方法采用VITEK细菌鉴定仪对伤口分泌物培养出的细菌进行鉴定,用纸片扩散法(Kirby-Bauer)对分离菌进行常规药敏试验,参照2009版CLSI标准判定药敏结果,并用WHONE5.4软件统计分析. 结果 628份伤口分泌物标本(包括开放性和闭锁性伤口分泌物)中共分离出病原菌483株,分离率为76.9%.分离率最高的依次是大肠埃希菌(21.1%)、金黄色葡萄球菌(18.0%)、铜假单胞菌(9.7%)、肺炎克雷伯菌(6.4%)及鲍曼不动杆菌(6.2%),革兰阴性杆菌均对亚胺培南敏感;葡萄球菌中MRSA和MRS分别为30.6%和86.6%. 结论伤口分泌物中分离出的菌种复杂且耐药问题严重,医务人员应重视临床标本的送检及加强抗菌药物使用的管理制度,以有效控制细菌感染和耐药.

Objective To investigate the common Pathogenic bacterias distribution and antibiotics analysis of wounds secretion in surgery so as to provide scientific evidence for antibiotics choice of wound infection in clinical. Methods Antimicrobial susceptibility test was carried out by Kirby-Bauer method. Results was analyzed according to CLSI 2009. The data were analyzed using WHONET 5.4 software. Results Totally 483 strains of pathogens were isolated from 628 specimens, which isolating rate was 76.9%. The most bacterial was E. coil(21.2% ), followed by S. aureus(18.0%), P. aeruginosa(9.7% ), K. pneumoniae(6.4% )and A. baumannii(6.2% ). Gram bacterias were all sensitive to imipenem. 30. 6% of S. aureus were identified as methicillin-resistant Staphylococcus, 86.6% of coagulase negative Staphylococcus isolates were methilillin-resistant. Conclusions The bacteria species is diversity in wound secretion , and their drug resistance is serious, so medical staff should to pay attention to the bacterial culture of clinical specimen and the monitoring bacteria resistance and anti-bacteria drug should be managed by system to control bacterial infection and drug resistance.