Analysis Of Pathogenic Bacteria And Drug Resistance Of Patients With Deep Infection After Lumbar Operation

Objective: To carry out bacterial culture and drug susceptibility test for patients with deep incision infection after the operation of lumbar degenerative diseases,To understand the microbial distribution of patients with deep infection after lumbar operation,and to provide guidance for the application of antibiotics in patients with deep infection after lumbar surgery.Methods: A total of 36 patients treated at the Affiliated Hospital of Qingdao University from August 2015 to May 2017 were selected for the first time because of lumbar degenerative diseases undergoing decompression and fusion surgery,and deep incision infections occurred after surgery.Those patients underwent debridement and continuous irrigation surgery after their first operations.The routine isolation,culture and identification of pathogenic bacteria in patients with deep incision after lumbar spine were performed,and their drug resistance was analyzed.At the same time,23 patients who underwent surgery for primary lumbar infection were selected as control.All specimens were submitted for three times.The first time was the lesion tissue or pus obtained during the debridement.The second time,the head of the inlet tube was continuously washed after surgery.The third time,the head of the outlet tube was continuously washed.Results: Among the patients with deep incision infection after lumbar degenerative disease,Gram-positive cocci accounted for 61.11%,of which Staphylococcus epidermidis was the largest,accounting for 45.45% of Gram-positive cocci,followed by Staphylococcus aureus,accounting for Gram-positive cocci 22.72%.Gram-negative bacilli accounted for 38.89%,of which more common E.coli,K lebsiella pneumoniae pneumonia,Pseudomonas aeruginosa,Acinetobacter baumannii.In the case of primary suppurative lumbar infections,Gram-positive cocci accounted for 65.22%,of which Staphylococcus aureus accounted for 60% of Gram-positive cocci,followed by coagulase-negative Staphylococcus 40%.Including Staphylococcus aureus,Streptococcus angina,Staphylococcus saprophytic,Streptococcus mitis,Staphylococcus urea subsp.urea and Staphylococcus staphylococcus,the proportion was 6.77% respectively.No Staphylococcus epidermidis was cultured.Gram-negative bacilli accounted for 34.78%,of which more common E.coli,Pseudomonas aeruginosa,K lebsiella pneumoniae pneumonia,Salmonella enterica double Arizona subspecies,C itrobacter freundii.There was no statistically significant difference between Gram-positive cocci and Gramnegative bacilli and Escherichia coli in the two groups(p>0.05),and the proportion of Staphylococcus aureus and Staphylococcus epidermidis was statistically significant(p<0.05).Gram-positive cocci had the highest sensitivity to vancomycin.The results ofdifferent kinds of Gram-negative bacilli were significant.Conclusion: Staphylococcus epidermidis,Staphylococcus aureus,Escherichia coli,Klebsiella pneumoniae pneumonia subspecies and Pseudomonas aeruginosa are still the main pathogens of type I incision infection in orthopedic plants.Staphylococcus epidermidis is the main strain of postoperative infection in patients with lumbar degenerative disease.Once the incision is infected,the secretion should be routinely cultured and drug sensitive test,and the use of antibiotics should be individualized according to the results of bacterial culture and drug susceptibility.Do accurate medication,not only based on the experience of the choice of antibiotics.