| Objective: Through the analyzing and understanding of the distribution and resistance characteristics of pathogenic bacteria infected with chronic refractory wounds in our department,to provide the reference for pre-treatment of chronic refractory wound infections and reasonable selection of antibiotics.Methods: To retrospective analysis the general information,distribution of pathogenic bacteria,and drug susceptibility of hospitalized patients with chronic refractory wounds from the First Affiliated Hospital of Guangxi Medical University from January 2013 to December 2017.Results:(1)There were 286 cases that met the inclusion criteria.Of the 402 samples submitted,263 strains of 41 pathogens were isolated.Among them,50 were Gram-positive bacteria(19.01%),169 were Gram-negative bacteria(64.26%)and fungi.44 strains(16.73%).(2)The four most pathogenic bacteria with the highest detection rate were Pseudomonas aeruginosa(54 isolates,20.53%),Staphylococcus aureus(39isolates,14.83%),and Escherichia coli(33 isolates,12.55%).Acinetobacter(17strains 6.46%).(3)Three Gram-negative bacteria with high detection rate were Pseudomonas aeruginosa(54 strains,20.53%),Escherichia coli(33 strains,12.55%),and Acinetobacter baumannii(17 strains,6.46%).Among them,the highest resistance to Pseudomonas aeruginosa was ampicillin,ceftriaxone and compound sulfamethoxazole.Their drug resistance was 61.11%,and the resistance to most other drugs was low,such as piperacillin/ Resistance to tazobactam,cefoperazone/sulbactam,levofloxacin,ciprofloxacin,imipenem,and minocycline is less than 20%,and resistance to amikacin and meropenem The average sex was only 5.56%;the resistance of E.coli to piperacillin,ampicillin,and sulfamethoxazole was higher than 80%,but for amoxicillin,piperacillin/tazobactam,cefotetan The resistance of cefuroxime axetil and cefoperazone/sulbactam was less than 10%.No resistance to tigecycline,imipenem,meropenem,and minocycline was found;Acinetobacter baumannii Most of the antibacterial drugs have developed resistance,their drug resistance is generally high,and the resistance of most drugs is above 55%.However,no resistance to tigecycline was found in this study.(4)The most common pathogen in Gram-positive bacteria was Staphylococcus aureus(39 strains,14.83%),and the resistance to benzylpenicillin was as high as 94.49%.No teicoplanin,vancomycin,and linezolid were found.Amine resistance;12 strains of methicillin-resistant Staphylococcus aureus(MRSA)were detected in the detected Staphylococcus aureus and accounted for 30.77%.The resistance was high,and the resistance to benzylpenicillin and oxacillin was 100%.At the same time,it has not been found to be resistant to teicoplanin,vancomycin and linezolid.Conclusion: Through a comprehensive analysis of the distribution and drug resistance of pathogenic infections in chronic refractory wounds in ourdepartment,intervention measures can be taken in advance to more effectively treat chronic refractory wounds.1.The detection rate of gram-negative bacteria in chronic refractory wounds was significantly higher than that of gram-positive bacteria.2.The four most pathogenic bacteria with the highest detection rate of chronic refractory wounds were Pseudomonas aeruginosa,Staphylococcus aureus,Escherichia coli and Acinetobacter baumannii.3.The antibiotic resistance of Acinetobacter baumannii is generally high,so clinical attention should be paid to it.4.For the treatment of Staphylococcus aureus,vancomycin is still an effective therapeutic drug.At the same time,it has been found that Staphylococcus aureus has high drug sensitivity to teicoplanin and linezolid.5.For the treatment of chronic refractory wounds,if we can understand the distribution of pathogenic bacteria and drug resistance of chronic refractory wounds in a timely and accurate manner,it is of great significance in the selection of antibiotics and can quickly and effectively control infections.Accelerate the healing of wounds and shorten the course of treatment. |
PDF Full Text Request