Analysis Of Pathogen Spectrum And Drug Susceptibility Of Chronic Osteomyelitis

ObjectiveTo analyze the distribution and drug resistance of pathogens of patients with chronic osteomyelitis in2ed affiliated hospital of Zhejiang university from January2012to January2014, to provide reasonable guidance for clinical treatment.MethodsRetrospective analysis of bacterial culture and drug susceptibility test of patients with chronic osteomyelitis in our hospital from January2012to January2014.Results132cases of bacterial culture results in which97cases are positive, the positive rate is73.48%.102bacteria were isolated, of which the first three are Staphylococcus aureus27cases (26.47%), Pseudomonas aeruginosa14cases (13.73%), Enterobacter cloacae and E. coli each9cases (8.82%). There are5patients with mixed infection, Gram-positive cocci for45cases (44.12%), Gram-negative bacteria for57cases (55.88%)。Distribution of the lesion site:tibia,54cases, accounting for52.94%, followed by26cases of femur, accounting for25.49%. There are65cases of infection caused by open wounds, accounting for63.73%of the total number, fixation after closed wound are28cases, accounting for27.45%, the rest cases have no obvious cause. Pathogens of chronic osteomyelitis caused by open wounds:Staphylococcus aureus18cases, accounting for27.69%, Enterobacter cloacae accounting for12.31%, Escherichia coli accounting for10.77%; pathogens of chronic osteomyelitis which caused by internal fixation:Pseudomonas aeruginosa8cases, accounting for28.57%, Staphylococcus aureus for21.43%. For the Gram-positive cocci, vancomycin, linezolid, tigecycline and nitrofurantoin have high sensitivity. For Gram-negative bacteria, imipenem, ciprofloxacin, amikacin, meropenem, gentamicin has a higher sensitivity, and cotrimoxazole, aztreonam and other traditional medicines have lost most of their sensitivity.ConclusionThe four most common pathogens of chronic osteomyelitis in our hospital are: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coliand, Enterobacter cloacae; Distribution of the lesion site:about half of the patients are tibia chronic osteomyelitis, quarter of the patients are femur chronic osteomyelitis. The most common cause of chronic osteomyelitis is open wound in our hospital, accounting for about2/3. The most common pathogens of chronic osteomyelitis which caused by open wound are Staphylococcus aureus, Enterobacter cloacae and E. coli, the most common pathogens of chronic osteomyelitis which caused by internal fixation are Staphylococcus aureus, Pseudomonas aeruginosa. For patients with chronic osteomyelitis in our hospital, many traditional antibiotics have lost the sensitivity. For patients with Gram-positive cocci, nitrofurantoin, vancomycin, linezolid, tigecycline have a relatively higher drug sensitivity; for patients with Gram-negative bacteria, ciprofloxacin, imipenem, meropenem have a relatively higher drug sensitivity.