Zhou Chenliang, Chen Xiaobing, Wu Liwen, Qu Jing
Department of Orthopedic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China.
The People's Hospital in Altay Region, Altay, Xinjiang 836500, P.R. China.
Exp Ther Med. 2016 Jun;11(6):2229-2232. doi: 10.3892/etm.2016.3239. Epub 2016 Apr 8.
Open wound may lead to infection in patients. Due to overuse of medication, certain bacteria have become resistant to drugs currently available. The aim of the present study was to provide a guide to ameliorate the appropriate and rational use of clinical antimicrobial agents by analyzing the distribution of drug-resistant pathogenic bacteria in patients. Between October 2013 and January 2015, 126 patients were selected at the Department of Orthopedics. Wound secretion samples were collected, and the pathogen bacteria isolated and identified. Identification was performed using an automated identification instrument and the Kirby-Bauer antibiotic method was used to evaluate the bacterial resistance. Of the 126 patients, 118 patients were infected (infection rate, 93.65%). Additionally, 47 strains of gram-positive pathogenic bacteria (39.83%) and 71 strains of pathogenic-gram negative bacteria (60.17%) were identified. The bacteria were most likely to be resistant to penicillin while sensitive to vancomycin and imipenem. Some bacteria were resistant to several antibacterial agents. The results showed that existing risk factors at the Department of Orthopedics were complex and any non-standard procedures were able to cause bacterial infection. There were obvious dissimilarities among infectious bacteria with regard to their sensitivity to various antibacterial agents. Manipulation techniques during the treatment process were performed in a sterile manner and the use of antibacterial agents was required to be strictly in accordance with the results of drug sensitivity tests to provide effective etiologic information and a treatment plan for clinical trials and to reduce the risk of infection by multi-resistant bacteria.
开放性伤口可能导致患者感染。由于药物的过度使用，某些细菌已对目前可用的药物产生耐药性。本研究的目的是通过分析患者耐药病原菌的分布情况，为改善临床抗菌药物的合理使用提供指导。2013年10月至2015年1月期间，在骨科选取了126例患者。采集伤口分泌物样本，分离并鉴定病原菌。使用自动鉴定仪器进行鉴定，并采用 Kirby-Bauer 抗生素法评估细菌耐药性。126例患者中，118例患者发生感染（感染率为93.65%）。此外，鉴定出47株革兰氏阳性病原菌（39.83%）和71株革兰氏阴性病原菌（60.17%）。这些细菌对青霉素耐药性最强，而对万古霉素和亚胺培南敏感。一些细菌对多种抗菌药物耐药。结果表明，骨科现有的危险因素复杂，任何不规范的操作都可能导致细菌感染。感染细菌对各种抗菌药物的敏感性存在明显差异。治疗过程中的操作技术需在无菌条件下进行，抗菌药物的使用必须严格按照药敏试验结果，以提供有效的病因学信息和治疗方案用于临床试验，并降低多重耐药菌感染的风险。
