69例坏死性筋膜炎患者的病原菌分布与细菌耐药性分析.docx

69例坏死性筋膜炎患者的病原菌分布与细菌耐药性分析

[关键词]坏死性筋膜炎；病原菌分布；细菌耐药性；病原菌检测；抗生素

[中图分类号]R634[文献标识码]A[DOI]10.3969/j.issn.1673-9701.2025.06.012

Pathogendistributionandantibioticresistanceanalysisof69casesofnecrotizingfasciitis

CHENYingbin1，HUANGYintao2，SHOUJiabao1，SONGRui1

1.DepartmentofTraumaRepairandBurnPlasticSurgery，LiuzhouWorkers’Hospital，Liuzhou545005，Guangxi，China;2.DepartmentofEmergencyMedicine，LiuzhouWorkers’Hospital，Liuzhou545005，Guangxi，China

[Abstract]ObjectiveTosummarizethepathogendistributionandantibioticresistancecharacteristicsof69casesofnecrotizingfasciitis（NF），providingevidencetosupportearlyclinicalantimicrobialtherapy.MethodsAretrospectiveanalysiswasconductedonmicrobialcultureandantibioticsusceptibilitytestresultsfrom69NFcasestreatedintheDepartmentofTraumaRepairandBurnPlasticSurgery，LiuzhouWorkers’HospitalfromJanuary2017toDecember2023.ResultsAtotalof77bacterialstrainswerecultured，including24Gram-positivebacteria，48Gram-negativebacteria，and5fungi.Monomicrobialinfectionwaspredominant，accountingfor66.07%ofthecases.AmongtheGram-positivebacteria，Staphylococcusaureuswasthemostcommon，separatedout10strains（12.99%），followedbyStreptococcuspyogenesin5strains（6.49%）.AmongtheGram-negativebacteria，Klebsiellapneumoniae（13strains，16.88%）andEscherichiacoli（10strains，12.99%）weremostfrequentlyidentified.Atotalof18multidrug-resistantstrainswerefound，representing23.38%ofallisolates.Gram-positivebacteriaweremostsensitivetovancomycin，linezolid，andtigecycline，whileGram-negativebacteriashowedthegreatestsensitivitytomeropenem，cefoperazone，andertapenem.ConclusionInthestudyarea，KlebsiellapneumoniaeisthemostcommonpathogencausingNF.Theinitialantimicrobialregimenshouldincludevancomycincombinedwithmeropenem，whichmaysignificantlyenhancetheeffectivenessofinfectioncontrol.

[Keywords]Necrotizingfasciitis;Pathogendistribution;Antibioticresistance;Pathogendetection;Antibiotics

1资料与方法

1.1一般资料

1.2标本收集

术前先用生理盐水冲洗溃疡创面，并去除创面表面的坏死组织和渗出物，将拭子擦洗并以“Z”模式滚动于创面基底，然后放入无菌试管。术中取深筋膜坏死组织做细菌培养。优先选择术中组织细菌培养结果，如无结果，选择术前拭子培养结果。