【作者】 韩善桥； 虞积耀； 王大鹏； 刘瑾红； 何立东； 胡明；

【Author】 HAN Shan-qiao,YU Ji-yao,WANG Da-peng,et al.(Navy General Hospital,Beijing 100048,China)

【机构】 中国人民解放军海军总医院；

【摘要】 目的了解腹部开放伤合并海水浸泡动物感染细菌对抗菌药物的敏感性。方法制作兔腹部开放伤动物感染实验模型并分成实验组和对照组,实验组致伤后放海水浸泡20分钟,对照组致伤后不放海水浸泡。于伤后0、12、24、48、72h进行大体观察及细菌学定量检测,细菌学鉴定使用全自动微生物分析仪,抗菌药物敏感性试验采用K-B纸片琼脂扩散法。结果两组动物伤口单位组织中细菌数均随时间延长而增加,且同一时间实验组细菌数比对照组高,两者差异有显著性(P<0.05)。腹部开放伤合并海水浸泡组动物伤口感染主要细菌有大肠埃希菌、奇异变形杆菌、鲍曼不动杆菌、金黄色葡萄球菌和副溶血弧菌,血液感染主要细菌有大肠埃希菌和副溶血弧菌。细菌药敏实验结果显示,对革兰阴性菌敏感率大于70%的抗菌药物包括头孢他啶、头孢噻肟、头孢哌酮、头孢吡肟、哌拉西林、氨曲南、庆大霉素、阿米卡星、奈替米星、左氧氟沙星、环丙沙星、亚胺培南和头孢哌酮/舒巴坦;对革兰阳性球菌敏感率大于70%的抗菌药物包括环丙沙星、左氧氟沙星、庆大霉素、阿米卡星、奈替米星、替考拉宁和万古霉素。结论腹部开放伤合并海水浸泡可导致严重的细菌感染,应早期使用广谱抗生素进行联合抗感染治疗。更多还原

【Abstract】 Objective To investigate the antimicrobial susceptibility of bacterial infection in rabbits after the open abdominal wound was immersed with seawater.Methods The animal infection models with open abdominal wounds were built in rabbits and randomly divided into two groups, experimental group and control group.The wounds of rabbits in the experimental group were then immersed into seawater for 20 minutes while those in the control group were not.Gross observation and quantiative bacterial analysis were performed at 0,12,24,48 and 72h after the injury respectively.Bacteria were identified manually and by VITEK Auto Microbe System.Antimicrobial susceptibility tests were performed by K-B method.Results Bacterial quantity in both of the two groups tended to increase with time,but at each time point after the injury,the experimental group had higher bacterial count than the control group(P <0.05).The main bacteria in the wounds of rabbits in the experimental group included Escherichia coli,Proteus mirabilis,Acinetobacter baumannii,Staphylococcus aureus and Vibrio parahaemolyticus.Escherichia coli and Vibrio parahaemolyticus were also detected in the blood.The susceptibilities of the Gram-negative bacilli to 17 kinds of antibiotics were tests,the susceptibility rates to ceftazidime,cefotaxime,cefoperazone,cefepime,piperacillin,aztreonam, gentamicin,amikacin,netilmicin,levofloxacin,ciprofloxacin,imipenem and cefoperazone/sulbactam were more than 70%.The susceptibilities of the Gram-positive cocci to 12 kinds of antibiotics were tests,the susceptibility rates to ciprofloxacin,levofloxacin,gentamicin,amikacin,netilmicin,teicoplanin and vancomycin were more than 70%.Conclusion Severe bacterial infection may develop if the open abdominal wound is immersed with seawater.Broad-spectrum antibiotics should be recommended in early stage.更多还原