标题：脊柱后路内固定术后手术部位深部感染的微生物与药敏学研究

      作者：张志彬，周素香，武雷，安文涛，李凯华，刘恩，陈志东，李瑞平
    (冀中能源峰峰集团公司总医院骨四科，河北 邯郸 056200)

      卷次： 2016年27卷13期

      【摘要】 目的 研究脊柱后路内固定术后手术部位深部感染的微生物与药敏学。方法 选择2010年1月至
2015年1月在我院行脊柱后路内固定术后手术部位深部感染患者65例，取所有患者的脓液、分泌物及穿刺液等进
行微生物培养，并进行药敏学测试。结果 65例患者微生物培养结果显示，共培养出130株微生物，104株革兰氏
阳性球菌，26株革兰氏阴性杆菌；革兰氏阳性球菌对青霉素、克林霉素、红霉素耐药性较高，均高于60%，对甲氧西
林、美罗培南、头孢呋辛、头孢噻肟、头孢曲松钠、庆大霉素等抗生素的耐药率为30%~40%；革兰氏阴性杆菌对氨苄
西林、头孢唑林、头孢呋辛等抗生素的耐药率均高于80%，对哌拉西林、头孢噻肟、头孢曲松钠、复方磺胺甲恶唑等
抗生素的抗药性为50%~60%；革兰氏阳性球菌对万古霉素、利奈唑胺、替考拉宁具有较好的敏感性。结论 脊柱
后路内固定术后手术部位深部感染微生物以革兰氏阳性球菌为主，革兰氏阳性球菌对万古霉素、利奈唑胺、替考拉
宁具有较好的敏感性，适合于长期使用抗生素治疗的患者。

      【关键词】 脊柱；后路内固定术；手术部位深部感染；微生物；药敏学

      【中图分类号】 R687.3 【文献标识码】 A 【文章编号】 1003—6350（2016）13—2127—03


Microorganism and drug sensitivity study of deep surgical site infections after posterior spinal internal fixation.
ZHANG Zhi-bin, ZHOU Su-xiang, WU Lei, AN Wen-tao, LI Kai-hua, LIU En, CHEN Zhi-dong, LI Rui-ping.
The Fouth
Department of Orthopaedics, Jizhong Energy Fengfeng Group Hospital, Handan 056200, Hebei, CHINA

【Abstract】 Objective To study the microorganism and drug sensitivity of deep surgical site infections after
posterior spinal internal fixation. Methods Sixty-five patients undergoing deep surgical site infections after posterior
spinal internal fixation from January 2010 to January 2015 were selected. The pus, secretion and puncture fluid of all the
patients were cultured, and the drug sensitivity test was carried out. Results A total of 130 strains of bacteria were obtained,
including 104 strains of Gram-positive cocci and 26 strains of Gram-negative bacilli. The Gram-positive cocci had high
resistance of more than 60% to penicillin, clindamycin, erythromycin and resistance of 30%~40% to methicillin, merope-
nem, cefuroxime, cefotaxime, ceftriaxone sodium and gentamicin. The Gram-negative bacilli had high resistance of
more than 80% to ampicillin, cefazolin, cefuroxime and relatively high resistance of 50%~60% to piperacillin, cefotaxi-
me, ceftriaxone sodium, compound sulfamethoxazole. Gram-positive cocci were sensitive to vancomycin, linezolid, tei-
coplanin. Conclusion Microorganisms isolated from surgical site with deep infections after posterior spinal internal fix-
ation are mainly Gram-positive cocci, which are sensitive to vancomycin, linezolid, teicoplanin. The three drugs are suit-
able for treating patients with long-term use of antibiotics.

      【Key words】 Spine; Posterior internal fixation; Deep surgical site infections; Microorganism; Drug sensitivity
·论 著·
6350.2016.13.022