%0 Journal Article
%T 下肢慢性创伤性骨髓炎患者感染病原菌情况分析
%A 董洪先
%A 黄富国
%A 钟刚
%A 肖聪
%A 刘国明
%A 靳家诚
%A 陈彦影
%J 华西医学
%P 28-32
%D 2012
%R CNKI:51-1356/R.20120115.1604.045
%X 目的　分析下肢慢性创伤性骨髓炎患者创面细菌培养分布情况，为临床用药提供依据。方法　对2006年1月－2010年12月收治的91例慢性骨髓炎患者创面分泌物细菌培养标本结果进行回顾性调查分析。其中男78例，女13例；年龄5～78岁，平均41.3岁。病程47d～7个月，平均68.6d。使用抗生素总疗程均＞7d。结果　65例创面细菌培养阳性患者共分离出113株病原菌，其中G?菌72株，占63.71%；G+菌41株，占36.28%。药敏结果显示，G+菌对常规青霉素类基本耐药，碳青霉烯类耐药菌株少见，对万古霉素耐药菌株尚未出现。G?菌对青霉素类及头孢菌素类耐药较高，对头孢哌酮－舒巴坦无耐药。结论　加强对慢性创伤性骨髓炎患者创面病原菌监测极为必要,对临床抗生素的合理使用具有一定的指导意义。Objective　Toanalyzethedistributionofculturedbacteriafromchronicosteomyelitispatients,andprovideabasisforclinicalmedicine.Methods　Weretrospectivelyanalyzedthebacterialcultureresultsofthesecretionsfrom91patientswithchronicosteomyelitistreatedinourhospitalfromJanuary2006toDecember2010.Amongthem,therewere78malesand13femalesagedfrom5to78yearsaveragingat(41.3±8.35)years.Thedurationofthediseaserangedfrom47daystomorethan7months,averaging(68.6±14.57)days.Thetotalcourseofantibiotic-takingwaslongerthan7daysforallthepatients.Results　Atotalof113pathogenstrainswereisolatedfrom65secretionsamples,including72Gram-negativebacteriaaccountingfor63.71%and41gram-positivebacteriaaccountingfor36.28%.DrugsusceptibilityresultsshowedbasicresistanceofGram-positivebacteriatoconventionalpenicillin,rareresistancetocarbapenem,andnoresistancetovancomycin.Gram-negativebacteriawerebasicallyresistanttopenicillinandcephalosporins,butnotresistanttocefoperazone-sulbactam.Conclusion　Enhancingthemonitoringofpathogensforpatientswithchronicosteomyelitisisextremelynecessaryfortherationalclinicaluseofantibiotics.
%K 慢性创伤性骨髓炎
%K 病原菌
%K 药敏
%K 耐药
%K 抗生素
%U http://www.hxyxqk.com.cn/oa/DArticle.aspx?type=view&id=201201008