Retrospective Analysis Of 297 Infected Patients Of Hand Surgery And Research Of Prevention And Treatment Of Window Period

Objective:To analysis the incidence characteristics,the bacteria distribution of wound secretion and the results of drug susceptibility test of infected patients from hand surgery of China-Japan Union Hospital of Jilin University.Combining the actual clinical efficacy,and provide evidence for the treatment of infection and empirical use of antibiotics in hand surgical infections of window period.Method:To collect the general information,the bacteria distribution of wound secretion and the results of drug susceptibility test of infected patients from hand surgery of China-Japan Union Hospital of Jilin University during October 2015 to October2017,and take retrospective analysis of these data.Result:Mean age(42.1±14.0)years old.Among all patients,240 are males(80.81%),and57 are females(19.19%).Among the 297 patients,17 patients(5.72%)are infected after undergoing clean surgery,mainly caused by staphylococcus aureus.201 patients(67.68%)are infected after undergoing clean-contamination surgery and contamination surgery,mainly caused by staphylococcus epidermidis.79 patients(26.60%)are definite developed infection at the time of admission,mainly caused by staphylococcus aureus.Among the different injury mechanisms,The highest proportion are winched by agricultural mechanica,total 105 cases.And 29 cases are crushed and bruised,11 cases are injured by chainsaw,and 10 cases are cut.According to the result bacterial culturing,406 strains of 54 species of bacteria were isolated,gram-positive bacteria accounted for 178 strains(43.84%),and gram-negative bacteriaaccounted for 228 strains(56.16%).Staphylococcus aureus(15.76%),staphylococcus epidermidis(14.04%),enterobacter cloacae(10.34%),serratia marcescens(9.85%)accounted for a relatively high proportion.According to the drug susceptibility test,linezolid(100%),tigecycline(100%),vancomycin(98.88%),meropenem(96.94%),amikacin(95.05%),cefepime(93.69%),imipenem(91.37%),ceftazidime(87.86%)and levofloxacin(80.00%)have a high sensitivity rate.The detection rates of methicillin-resistant staphylococcus aureus and methicillin-resistant staphylococcus epidermidis were 9.38% and 71.93%.No test for vancomycin-resistant,linezolid-resistant and tigecycline-resistant strains among staphylococcus was positive.And no test for carbapenem-resistant strains among enterobacter cloacae and serratia marcescens was positive.The sensitivity rate of enterobacter cloacae to ceftriaxone was 83.33%,and 90.48% to ceftazidime.The sensitivity rate of serratia marcescens to ceftriaxone was 100%,and 97.5% to ceftazidime.Conclusion:1.Infection of hand surgery is mainly caused by trauma,and winched by agricultural mechanical is the most common injury mechanism for infection.2.There is a variety of pathogenic bacteria in the infection of hand surgery.Gbacteria is a little common than G+ bacteria.Staphylococcus aureus,staphylococcus epidermidis,enterobacter cloacae,and serratia marcescens are the most common pathogenic bacteria.3.For the window period's prevention of hand surgery infections,the first generation of cephalosporin and penicillinase-stabilized penicillin can be used as the preferred empirical antibiotic.The third and fourth-generation cephalosporins and quinolones antibiotics can be used as the preferred antibiotic for infected patients with open trauma as well as the possibility of G-bacillus infection.