Distribution and drug resistance of pathogens isolated from wounds in orthopedic patients
10.3760/cma.j.issn.1674-2397.2013.02.011
- VernacularTitle:骨科患者伤口感染病原菌的分布及耐药性
- Author:
Wei GAO
;
Peng WANG
;
Xiangmin TONG
;
Xiaocheng WANG
- Publication Type:Journal Article
- Keywords:
Wound;
Infection;
Orthopedics;
Pathogens;
Drug resistance
- From:
Chinese Journal of Clinical Infectious Diseases
2013;(2):104-107
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the distribution and drug resistance of pathogens isolated from wounds in orthopedic patients.Methods Wound samples were collected from 999 orthopedic patients in the Third Hospital of Hebei Medical University during July 2010 and June 2012.Pathogens were isolated and identified.The antimicrobial susceptibility test was performed by Kirby-Bauer method.Extended spectrum β-1actamases (ESBLs) were detected by double-disk diffusion test,and methicillin-resistant Staphylococcus aureus (MRSA) was detected by cefoxitin disk diffusion test.WHONET 5.4 was used for drug resistance analysis.Results A total of 1056 strains of pathogens were isolated,of which gram-positive cocci,gramnegative organisms and fungi accounted for 69.98% (739/1056),28.79% (304/1056),and 1.23%(13/1056),respectively.The top 5 pathogens were Staphylococcus aureus (265.25.09%).Pseudomonas aeruginosa (245,23.20%),Acinetobacter baumannii (199,18.84%) and Escherichia coli (86,8.14%).The resistant rates of Pseudomonas aeruginosa to cefoperazone/sulbactam,ciprofloxacin,levofloxacin and piperacillin/tazobactam were 13.58%,21.25%,21.67% and 22.45%,while the highest resistance rate was to compound sulfamethoxazole (98.04%).Acinetobacter baumannii was highly resistant to most antibacterial agents except cefoperazone/sulbactam (14.29%),and 11 out of 199 strains were pandrug resistant.Enterobacteriaceae were completely susceptible to imipenem and meropenem,and their resistance rates to cefoperazone/sulbactam,piperacillin/tazobactam and amikacin were 1.16%-28.12%.ESBLs positive rates of Escherichia coli and Klebsiella pneumoniae were 48.84% (42/86) and 34.38%(11/32),respectively.Staphylococcus aureus were susceptible to vancomycin,teicoplanin and linezolid,but were highly resistant to ampicillin (100.00%),penicillin G (99.25%) and erythromycin (80.06%).The rate of MRSA was 41.51% (110/265).Enterococcus were highly resistant to erythromycin,rifampin,levofloxacin,high-concentration gentamicin,minocycline and nitrofurantoin,but were susceptible to teicoplanin and linezolid,and the rate of vancomycin intermediate strain was 4.55% (1/22).Conclusions The pathogens of wound infections in orthopedic patients were of wide variety.Staphylococcus aureus,Pseudomonas aeruginosa,Acinetobacter baumannii,Escherichia coli and Enterobacter cloacae were the most prevalent pathogens,and most strains were multi-drug resistant.