玉树地震藏族伤员感染病原菌的分布及药物敏感性分析
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摘要
目的回顾性分析玉树地震后藏族伤员感染病原菌的分布及药物敏感性。方法收集玉树地震伤员的各类标本并进行需氧、兼性厌氧和厌氧培养,分离菌以VITEK32全自动微生物分析仪鉴定到种,并用其配套试验板进行药物敏感性试验。结果 51例伤员共送检标本97份,检出细菌40株,以革兰阳性球菌为主,其次依次是革兰阴性杆菌、革兰阳性杆菌和真菌。感染菌包括葡萄球菌属、肠球菌属、链球菌属、杆菌属等12个菌属。革兰阳性球菌对临床常用抗菌药物敏感性较好。革兰阳性杆菌和革兰阴性杆菌对第3代和第4代头孢类、碳青霉烯类和β-内酰胺类复方抗菌药物敏感。结论高原地震伤员感染病原菌分布广泛,及时开展创面细菌学培养鉴定与药物敏感性试验对于伤员的合理抗感染治疗十分重要。
Objective To retrospectively analyze distribution and drug sensitivity of pathogens isolated from infected Tibetan wounded in Yushu earthquake.Methods Various specimens of wounded in Yushu earthquake were collected and subjected to aerobic,facultative anaerobic and anaerobic culture.VITEK32 fully automated microbiology analyzer was used to perform species identification of isolated pathogens,and drug sensitivity test was conducted on its supporting test board.Results Total of 97 specimens derived from 51 wounded were tested,and 40 bacterial strains were identified.The main strain was Gram-positive cocci,followed by Gram-negative bacilli,Gram-positive bacilli and fungi in sequence.Infected bacteria included 12 categories,such as Staphylococcus,Enterococcus,Streptococcus and Escherichia etc.Gram-positive cocci showed better sensitivity to antimicrobial agents commonly used in clinical treatment.Gram-positive bacilli and Gram-negative bacilli demonstrated sensitivity to third-and forth-generation cephalosporins,carbon carbapenems and β-lactam antimicrobial agents.Conclusion Pathogens isolated from infected wounded in plateau earthquake are widely distributed.It is very important to timely carry out wound bacteriology identification and drug sensitivity testing for reasonable anti-infection treatment.
Objective To retrospectively analyze distribution and drug sensitivity of pathogens isolated from infected Tibetan wounded in Yushu earthquake.Methods Various specimens of wounded in Yushu earthquake were collected and subjected to aerobic,facultative anaerobic and anaerobic culture.VITEK32 fully automated microbiology analyzer was used to perform species identification of isolated pathogens,and drug sensitivity test was conducted on its supporting test board.Results Total of 97 specimens derived from 51 wounded were tested,and 40 bacterial strains were identified.The main strain was Gram-positive cocci,followed by Gram-negative bacilli,Gram-positive bacilli and fungi in sequence.Infected bacteria included 12 categories,such as Staphylococcus,Enterococcus,Streptococcus and Escherichia etc.Gram-positive cocci showed better sensitivity to antimicrobial agents commonly used in clinical treatment.Gram-positive bacilli and Gram-negative bacilli demonstrated sensitivity to third-and forth-generation cephalosporins,carbon carbapenems and β-lactam antimicrobial agents.Conclusion Pathogens isolated from infected wounded in plateau earthquake are widely distributed.It is very important to timely carry out wound bacteriology identification and drug sensitivity testing for reasonable anti-infection treatment.
引文
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[13]Igusa R,Narumi S,Murakami K,et al.Escherichia coli pneu-monia in combination with fungal sinusitis and meningitis in atsunami survivor after the Great East Japan Earthquake[J].Tohoku J Exp Med,2012,227(3):179-184.
[14]Wang Y,Hao P,Lu B,et al.Causes of infection afterearthquake,China,2008[J].Emerg Infect Dis,2010,16(6):974-975.
[15]Maegele M,Gregor S,Steinhausen E,et al.The long-dis-tance tertiary air transfer and care of tsunami victims:in-jury pattern and microbiological and psychological aspects[J].Crit Care Med,2005,33(5):1136-1140.
[2]Benca J,Kalavsky E,Miklosko J,et al.Infectious diseasesin disaster areas/catastrophes[J].Neuro Endocrinol Lett,2007,28Suppl 2:S40-43.
[3]Kiani QH,Amir M,Ghazanfar MA,et al.Microbiology ofwound infections among hospitalised patients followingthe 2005Pakistan earthquake[J].J Hosp Infect,2009,73(1):71-78.
[4]颜英俊,喻华,周忠华,等.5.12汶川地震伤患者感染病原菌分布及药物敏感试验结果分析[J].四川医学,2009,30(2):248-251.
[5]Wang T,Li D,Xie Y,et al.The microbiological characte-ristics of patients with crush syndrome after the Wen-chuan earthquake[J].Scand J Infect Dis,2010,42(6/7):479-483.
[6]Ran YC,Ao XX,Liu L,et al.Microbiological study ofpathogenic bacteria isolated from paediatric wound infec-tions following the 2008Wenchuan earthquake[J].ScandJ Infect Dis,2010,42(5):347-350.
[7]Bakker DJ.Clostridial myonecrosis(gas gangrene)[J].Undersea Hyperb Med,2012,39(3):731-737.
[8]Bozkurt M,Okutur K,Aydin K,et al.Fulminant abdomi-nal gas gangrene in metastatic colon cancer[J].OncolLett,2012,3(2):469-471.
[9]Kos VN,Desjardins CA,Griggs A,et al.Comparative ge-nomics of vancomycin-resistant Staphylococcus aureusstrains and their positions within the clade most common-ly associated with Methicillin-resistant S.aureus hospital-acquired infection in the United States[J].MBio,2012,3(3):e00112.
[10]Thati V,Shivannavar CT,Gaddad SM.Vancomycin re-sistance among methicillin resistant Staphylococcus au-reus isolates from intensive care units of tertiary carehospitals in Hyderabad[J].Indian J Med Res,2011,134(5):704-708.
[11]Yoong P,Schuch R,Nelson D,et al.Identification of a broad-ly active phage lytic enzyme with lethal activity against anti-biotic-resistant Enterococcus fae calis and Enterococcus faeci-um[J].J Bacteriol,2004,186(14):4808-4812.
[12]Lim PL.Wound infections in tsunami survivors:a com-mentary[J].Ann Acad Med Singapore,2005,34(9):582-585.
[13]Igusa R,Narumi S,Murakami K,et al.Escherichia coli pneu-monia in combination with fungal sinusitis and meningitis in atsunami survivor after the Great East Japan Earthquake[J].Tohoku J Exp Med,2012,227(3):179-184.
[14]Wang Y,Hao P,Lu B,et al.Causes of infection afterearthquake,China,2008[J].Emerg Infect Dis,2010,16(6):974-975.
[15]Maegele M,Gregor S,Steinhausen E,et al.The long-dis-tance tertiary air transfer and care of tsunami victims:in-jury pattern and microbiological and psychological aspects[J].Crit Care Med,2005,33(5):1136-1140.
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