Pathogenic culture and detection of antimicrobial resistance of pathogens before and after debridement in patients with open fractures
10.3969/j.issn.1671-9638.2014.10.003
- VernacularTitle:开放性骨折患者清创前后创面病原学培养及耐药性
- Author:
Shaoxia LI
- Publication Type:Journal Article
- Keywords:
open fracture;
wound;
debridement;
bacteria;
pathogen;
healthcare-associated infection
- From:
Chinese Journal of Infection Control
2014;(10):588-591,595
- CountryChina
- Language:Chinese
-
Abstract:
Objective To realize the detection of pathogens and antimicrobial resistance of pathogens isolated from wound secretion in patients with open fractures,so as to guide clinical treatment.Methods 1 472 patients with open fractures from May 2012 to July 2013 were selected from a hospital,pathogens from wound secretions before and after debridement were identified and performed antimicrobial susceptibility testing.Results Before debride-ment,1 246 of 1 472 patients (84.65%)were isolated 2 246 bacterial strains,824 (55.98%)of patients were isola-ted at least 2 kinds of bacteria.Eight hours after debridement,201 pathogenic bacteria were isolated from 195 pa-tients (13.25%).The more serious of Gustilo type,the higher the positive rate of bacterial culture.Positive rate of wound culture were all >50% in patients of all Gustilo types before debridement;positive rate were all <5% in pa-tients of type I,Ⅱ and ⅢA,but type ⅢB and ⅢC were still high after debridement.Staphylococcus aureus and Staphylococcus epidermidis were sensitive to vancomycin,the resistant rates to furantoin were <5%,the resistant rates to penicillin G and erythromycin were all >75%.Acinetobacter baumannii had higher resistance to multiple antimicrobial agents,to cefoperazone/sulbactam was 20%;Pseudomonas aeruginosa to imipenem was 10.80%, sensitivity to cefoperazone/sulbactam,cefepime and ceftazidime were all higher.Conclusion For patients with open fractures,timely debridement can reduce wound pathogen,antimicrobial susceptibility testing result is helpful for guiding rational antimicrobial use.