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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 min,对照组致伤后不放海水浸泡。于伤后0、12、24、48、72 h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,两者差异有统计学意义(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。
Objective To investigate the sensitivity of antibacterials to infections caused by open wounds and seawater immersion animals. Methods Experimental animal models of open abdominal wound injury in rabbits were established and divided into experimental group and control group. The experimental group was immersed in seawater for 20 minutes after injury and the control group was immersed in seawater after injury. At 0, 12, 24, 48 and 72 hours after injury, the general observation and bacteriological examination were carried out. The bacteriological identification was performed by automatic microbiological analyzer. The antimicrobial susceptibility test was performed by K-B disc agar diffusion method. Results The number of bacteria per unit wound in both groups increased with time, and the number of bacteria in experimental group was higher than that in control group at the same time (P <0.05). The main bacteria of wound infection in open abdomen and seawater immersion group were Escherichia coli, Proteus mirabilis, Acinetobacter baumannii, Staphylococcus aureus and Vibrio parahaemolyticus. The main bacteria of blood infection were Escherichia coli and parahemolytic Vibrio. Bacterial susceptibility test results showed that the antimicrobial agents with a sensitivity of more than 70% to Gram-negative bacteria include ceftazidime, cefotaxime, cefoperazone, cefepime, piperacillin, aztreonam, gentamicin, Card star, netilmicin, levofloxacin, ciprofloxacin, imipenem and cefoperazone / sulbactam; antimicrobial agents with a sensitivity of more than 70% to gram-positive cocci include ciprofloxacin, levofloxacin, Daimycin, amikacin, netilmicin, teicoplanin and vancomycin. Conclusion Abdominal open wounds combined with seawater immersion can lead to serious bacterial infections. Early use of broad-spectrum antibiotics should be combined with anti-infective therapy.