摘要
目的探讨骨髓炎患者感染多重耐药菌(multiple resistant bacteria,MDR)的细菌谱及耐药性,为临床治疗提供依据。方法选取本院2017年1月—2019年12月骨髓炎患者1293例,分析感染部位细菌培养和药敏结果,获取MDR细菌谱特点和耐药性。结果1293例患者细菌培养阳性611例,检出病原菌659株,总检出率为47.3%。其中267例MDR感染,检出MDR 286株,占总检出病原菌的43.4%。286株MDR中革兰阳性菌150株,占52.4%,以MRSA为主;革兰阴性菌136株,占47.6%,大肠埃希菌、肺炎克雷伯、铜绿假单胞菌位居前三。MRSA对青霉素类、头孢菌素类完全耐药;对克林霉素、红霉素具有较高的耐药性;无万古霉素耐药菌株。主要的MDR革兰阴性菌对青霉素类和头孢菌素类几乎全部耐药,对碳青霉烯类耐药率较低。结论骨髓炎患者MDR感染率高且耐药广泛,感染部位细菌培养和药敏实验结果在临床治疗中发挥关键作用。
Objective To investigate the bacterial spectrum and drug resistance of patients with osteomyelitis infected with mul⁃tiple resistant bacteria(MDR),and to provide basis for clinical treatment.Methods A total of 1293 inpatients with osteomy⁃elitis from January 2017 to December 2019 were selected as the research objects.The bacterial culture and drug sensitivity results of infected sites were analyzed to obtain the characteristics of MDR bacterial spectrum and drug resistance.Results There were 611 of 1293 patients with positive bacterial culture,and 659 strains of pathogenic bacteria were detected,with a total detection rate of 47.3%.Among them,267 cases were MDR infection,and MDR 286 strains were detected,accounting for 43.4% of the total detected pathogens.Among the 286 strains of MDR,150 gram-positive bacteria,accounting for 52.4%,were mainly MRSA;136 gram-negative bacteria,accounting for 47.6%,Escherichia coli,Klebsiella pneumonia,and Pseudomonas aeruginosa are among the top three.MRSA is 100% resistant to penicillin antibiotics;it also has high resist⁃ance to clindamycin and erythromycin;no vancomycin-resistant strains have been found.The main MDR gram-negative bacteria are almost all resistant to penicillins and cephalosporins,and the resistance rate to carbapenems is low.Conclusion Osteomyeli⁃tis patients have a high MDR infection rate and a wide range of drug resistance.Bacterial culture and drug susceptibility test results at the infected site play a key role in clinical treatment.
作者
李向平
胡淼
李培岭
LI Xiang-ping;HU Miao;LI Pei-ling(Clinical Laboratory,Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hosptial),Zhengzhou,Henan 450000,China;不详)
出处
《中国卫生检验杂志》
CAS
2021年第15期1840-1842,共3页
Chinese Journal of Health Laboratory Technology
基金
2020年河南省科技攻关计划项目(202102310362)
2020年河南省中医药科学研究专项课题(20-21ZY2237)。
关键词
骨髓炎
多重耐药菌
治疗
Osteomyelitis
Multiple resistant bacteria
Treatment
