摘要
目的 分析创伤门诊慢性伤口感染病原菌的分布及其耐药性，以准确评估伤口情况，为临床合理使用抗生素或银离子敷料治疗感染慢性伤口及减少耐药菌产生提供科学依据。方法 回顾性分析本院伤口造口护理中心2013年7月～2014年12月创伤门诊慢性伤口分泌物标本病原菌培养和耐药性试验结果，应用软件WHONET 进行统计学分析。结果 创伤门诊慢性伤口病原菌培养阳性率58.48%，耐药率54.10%。金黄色葡萄球菌和大肠埃希菌检出率最高（22.95%和21.31%），耐药率分别为46.43%、69.23%。鲍曼不动杆菌100.00%耐药。各伤口部位感染率从高到低依次为上肢，骶尾部，下肢和颊部。不愈性手术伤口分泌物细菌培养阳性率为48.5%，其中金黄色葡萄球菌构成比为38.8%，包括2 例耐甲氧西林金黄色葡萄球菌（MASA）感染。结论 创伤门诊慢性伤口病原菌感染率和耐药率较高，临床医务工作者应加强无菌操作观念，避免医源性交叉感染，针对慢性伤口应及时行细菌培养和药敏试验以明确诊断和改进换药策略。
Objective To analyze the distribution and drug resistance of pathogenic bacteria in traumatic outpatient chronic wound infection,and to provide scientific evidence for clinical rational use of antibiotics or silver ion dressing in treating chronic wounds and reducing drug resistance.Methods The pathogenic bacteria culture and drug resistance of chronic wounds in a hospital traumatic outpatient from July 2013 to December 2014, and the results of drug resistance test were retrospectively analyzed. The software WHONET was used for statistical analysis. Results The culture-positive rate of pathogenic bacteria was 58.48%, and the detection rate of antibiotic-resistant bacteria was 54.10%. The top two pathogenic of positive rate were Staphylococcus aureus and Escherichia coli (22.95% and 21.31%, respectively), antibiotic-resistant bacteria account for 46.43% and 69.23%, respectively. All the Bauman Acinetobacter were antibiotic-resistant. The infection rate of different wound locations were as follows: upper extremity, sacrococcygeal, lower extremity, pars buccalis. The positive rate of bacterial culture was 38.8%, the composition ratio of Staphylococcus aureus was 48.5%, including 2 cases of Staphylococcus aureus (MASA) infection. Conclusion The infection rate and drug resistance rate of chronic wounds are high, the clinical medical workers should strengthen the aseptic operation concept to avoid iatrogenic cross-infection. In order to make a clear diagnosis and improve the dressing change strategy, the bacterial culture and drug sensitivity test should be performed in time.
出处
《当代医学》
2016年第22期3-5,共3页
Contemporary Medicine
关键词
慢性伤口
细菌
耐药性
银离子敷料
Chronic wound
Bacteria
Antibiotic resistance
Silver ion dressing
