【摘要】：目的探討下肢開放性骨折患者醫院感染的誘發性因素,分析其病原菌分布特點,以期臨床預防與治療提供依據。方法選取2011年2月-2016年8月醫院接診的下肢開放性骨折患者537例為研究對象,所有患者創口分泌物實施細菌培養,分析下肢開放性骨折醫院感染的誘發性因素,并統計病原菌分布特點。結果 537例患者中發生醫院感染26例,感染率為4.84%,單因素和Logistic法顯示:受傷至手術時間≥7d、Gustilo分型Ⅲ型、合并糖尿病、外固定、抗菌藥物使用劑量不足均為下肢開放性骨折醫院感染的獨立危險因素(P0.05);26例感染患者共分離病原菌49株,以革蘭陽性菌27株占55.10%,革蘭陰性菌20株占40.82%,革蘭陰性菌中銅綠假單胞菌對頭孢唑林耐藥率為87.50%,鮑氏不動桿菌對亞胺培南耐藥率為100.00%,大腸埃希菌對頭孢唑林耐藥率為100.00%;革蘭陽性菌中金黃色葡萄球菌對利福平耐藥率為88.89%,糞腸球菌對亞胺培南與美羅培南耐藥率為100.00%,表皮葡萄球菌對阿莫西林與氨芐西林耐藥率為100.00%。結論下肢開放性骨折患者醫院感染與多種因素有關,感染病原菌以革蘭陰性菌為主,臨床醫師應合理使用抗菌藥物,提高療效。
[Abstract]:Objective to investigate the inducing factors of nosocomial infection in patients with open fracture of lower extremities and analyze the distribution of pathogens in order to provide evidence for clinical prevention and treatment. Methods 537 patients with open fracture of lower extremity were selected from February 2011 to August 2016. The bacteria culture was carried out in the wound secretion of all patients, and the inducing factors of nosocomial infection of open fracture of lower extremity were analyzed. The distribution characteristics of pathogenic bacteria were analyzed. Results among the 537 patients, 26 had nosocomial infection, the infection rate was 4.84.The single factor and Logistic method showed that the time from injury to operation was more than 7 days and Gustilo type 鈪，

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