Clinical Isolation Of Pathogenic Bacteria From Orthopedics Of A Hospital Analysis Of Clinical Distribution And Drug Resistance Characteristics

Objective:To explore the clinical distribution of clinical isolated pathogens and their antimicrobial resistance in the department of orthopedics of the first affiliated hospital of Nanchang university from 2012 to 2017.Materials and methodsAll strains were isolated from the wound secretions,sputum,urine,blood and other clinical specimens sent to the orthopedics department of the first affiliated hospital of Nanchang university from 2012 to 2017.In other words,pathogenic bacteria were detected in the samples,and the duplicates isolated from the same patient were removed.VITEK 2-Compact instrument was used for bacterial identification.The drug susceptibility test was performed by automated instrument method,as per the paper diffusion method recommended by CLSI in 2017.WPS software was used for data processing of clinical isolates.The drug resistance rate of the top five strains in total was collected.Results:1.From 2012 to 2017,a total of 1392 strains of bacteria were isolated.The most common gram-negative bacteria were escherichia coli(14.6%),enterobacter cloacae(13.9%),pseudomonas aeruginosa(9.8%),acinetobacter baumannii(9.6%),and staphylococcus aureus(11.3%).2.The isolated bacterial strains were mainly from wound secretions,respiratory tract specimens,urine and blood,accounting for 65.6%,11.3%,16.0% and 4.3%?3.The detection rate of MRSA was 43.3%,The detection rate of MRCNS was40%.The drug resistance rate of staphylococcus aureus to amoxicillin/clavuric acid,tetracycline,compound xinnomin and chlorincomycin showed an increasing trend(P< 0.05).4.E.coli ESBLs strains detection rate was 80.9%,and klebsiella pneumoniae ESBLs strains detection rate by 26.5% and carbon penicillium alkene penicilliumdrug-resistant e.coli and carbon alkene drug-resistant pneumonia klebsiella bacteria detection rate was 2.9%(6/24)and 6.7%(3/64).From 2012 to 2017,the drug resistance rate of escherichia coli to compound sulfamethoxazole Granules showed an increasing trend(P < 0.05),From 2012 to 2016,the drug resistance rate of escherichia coli to cefazolin,ceftriaxone and ertapenem showed a decreasing trend(P< 0.05),From 2012 to 2017,the drug resistance rate of enterobacter cloacae to cefepime and triamcinolone showed an increasing trend(P < 0.05).5.A total of 55 strains of enterococcus were isolated from 2012 to 2017,including 44 strains of enterococcus faecalis(80%)and 11 strains of enterococcus faecalis(20%).The drug resistance rate of enterococcus faecalis to quinuptin/dafuptine was 97.1%,significantly higher than that of enterococcus faecalis to quinuptin/dafuptine,and the difference was statistically significant(P < 0.05).6.Pseudomonas aeruginosa to amikacin,levofloxacin,tobramycin,ciprofloxacin,Cefoperazone/sulbactam resistant rate below 30%.The drug resistance rate of acinetobacter baumannii to cefepime,levofloxacin,tobramycin,ceftazidime,gentamicin,ampicillin/sulbactam,pyracilin/tazobactam showed an increasing trend(P< 0.05).Conclusion:There is a slight difference between the monitoring report of drug sensitivity of bacteria in the department of orthopedics of our hospital and the national monitoring report,which is totally dependent on their own experience in drug use,often with errors.Clinicians should refer to the bacterial characteristics and drug sensitivity report,and combine the existing antibiotics in the hospital to better treat patients.