地震创伤性感染病原菌状况分析
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摘要
目的了解地震受伤患者创面感染情况,为抗感染治疗提供科学依据。方法对14例开放性骨折或骨筋膜室综合征患者的创面进行床边采样,并进行细菌、真菌和厌氧菌培养,根据病原菌生长情况进行药物敏感性试验。结果14例地震受伤患者中有10例的创面有细菌生长,感染率为71.43%;14例患者送检的17份标本中有12份细菌培养阳性,4份真菌培养阳性,1份厌氧菌培养阳性,阳性率分别为70.59%、23.53%和5.89%;未分离出产气荚膜梭菌和破伤风梭菌,初次分离病原菌以阴沟肠杆菌、凝固酶阴性葡萄球菌和不动杆菌属为主,并分离出5株真菌内1株假丝酵母菌属。结论灾区受伤患者伤口感染率高,创面多为混合感染,且存在医院感染,感染病原菌耐药严重,及时快速查找病原菌并根据药敏结果进行抗感染治疗是治疗创伤感染的关键。
OBJECTIVE To investigate the status of traumatic infection among earthquake in order to provide reasonable evidence for anti-infective therapy. METHODS Samples were collected from 14 patients with compound fracture or osteofascial compartment syndrome for bacterial,fungal and anaerobic culturing,then according to pathogens to choose antimicrobial susceptibility test (AST). RESULTS Among 14 victims,10 had germ growth in wound secretions,the infection rate was 71.43%. Among 17 samples the bacteria,fungi and anaerobic were isolated in 12,4 and (samples,respectively),the isolated rates were 70.59%,23.53% and 5.89%. The main pathogens for the first culture were Enterobacter cloacae,coagulase negative Staphylococcus (CNS) and Acinetobacter. The Clostridium tetani and C. perfringens were all negative. We also isolated 5 strains of fungi from them 1 strain of Candida. CONCLUSIONS Most of the victims from disaster area have got bacterial infection. Most of them are combined infection,some of the infections are nosocomial infections. The key points of the treatment are to find pathogens immediately and choose a reasonable antibacterial agents according to the AST.
OBJECTIVE To investigate the status of traumatic infection among earthquake in order to provide reasonable evidence for anti-infective therapy. METHODS Samples were collected from 14 patients with compound fracture or osteofascial compartment syndrome for bacterial,fungal and anaerobic culturing,then according to pathogens to choose antimicrobial susceptibility test (AST). RESULTS Among 14 victims,10 had germ growth in wound secretions,the infection rate was 71.43%. Among 17 samples the bacteria,fungi and anaerobic were isolated in 12,4 and (samples,respectively),the isolated rates were 70.59%,23.53% and 5.89%. The main pathogens for the first culture were Enterobacter cloacae,coagulase negative Staphylococcus (CNS) and Acinetobacter. The Clostridium tetani and C. perfringens were all negative. We also isolated 5 strains of fungi from them 1 strain of Candida. CONCLUSIONS Most of the victims from disaster area have got bacterial infection. Most of them are combined infection,some of the infections are nosocomial infections. The key points of the treatment are to find pathogens immediately and choose a reasonable antibacterial agents according to the AST.
引文
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[2]黄寿清,张楚南,李向阳,等.开放性骨折创面处理与创面感染的关系[J].中国感染控制杂志,2003,2(3):170-171.
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[5]石海鸥,王力红,张京利,等.抗菌药物应用合理性干预前后对比分析[J].中华医院感染学杂志,2006,16(4):428-430.
[6]王贺,徐英春,陈民钧.细菌质粒介导的喹诺酮类抗菌药物耐药机制研究进展[J].中华医院感染学杂志,2007,17(5):618-620.
[7]尤荣开,陈秀平,邵朝朝,等.创伤弧菌对常用抗菌药物的敏感性[J].中华医院感染学杂志,2007,17(10):1312-1313.
[2]黄寿清,张楚南,李向阳,等.开放性骨折创面处理与创面感染的关系[J].中国感染控制杂志,2003,2(3):170-171.
[3]李六亿,陈菁.医疗器械的清洗与去污[J].中华医院感染学杂志,2007,17(11):1458-1460.
[4]王颖莹,王辰允,张伟,等.野战环境下医院感染的预防与控制[J].中华医院感染学杂志,2008,18(3):363-365.
[5]石海鸥,王力红,张京利,等.抗菌药物应用合理性干预前后对比分析[J].中华医院感染学杂志,2006,16(4):428-430.
[6]王贺,徐英春,陈民钧.细菌质粒介导的喹诺酮类抗菌药物耐药机制研究进展[J].中华医院感染学杂志,2007,17(5):618-620.
[7]尤荣开,陈秀平,邵朝朝,等.创伤弧菌对常用抗菌药物的敏感性[J].中华医院感染学杂志,2007,17(10):1312-1313.
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