高效净水细菌的分离鉴定及其净水能力分析

[目的]分离筛选获得能高效净化污水的净化细菌。[方法]利用氨氮降解筛选培养基对某污水处理厂的活性污泥进行净水细菌的分离筛选,并研究分离菌株对污水有机质、氨态氮、总磷与总氮含量的去除效果以及药敏性分析。[结果]比较去除效果,获得了1株最高效的净水细菌,该菌株对污水有机质、氨态氮、总氮与总磷均具有较强的净化效果,其去除率分别达58. 90%、65. 45%、51. 91%和35. 00%。结合菌落形态特征观察、生理生化分析及分子鉴定,鉴定该菌株为暹罗芽胞杆菌(Bacillus siamensis)。该菌株对7种常见抗生素均具有一定敏感性,其中对氨苄青霉素最敏感,卡那霉素次之,对庆大霉素最不敏感。[结论]分离筛选获得1株能高效净化污水的暹罗芽胞杆菌,对常见抗生素具有一定敏感性。     

碳青霉烯耐药肠杆菌科细菌的监测与分析

【摘 要】 目的 调查某医院碳青霉烯耐药肠杆菌科细菌（carbapenem-resistant Enterobacteriaceae,CRE）的分布及耐药性。方法 收集2010年至2012年门、急诊和住院患者的细菌培养和药敏结果,对碳青霉烯耐药肠杆菌科细菌感染病例进行回顾性分析追踪。结果 共检出碳青霉烯耐药肠杆菌科细菌9株,均来自ICU,阴沟肠杆菌5株,占55.6%,肺炎克雷伯菌3株,占33.3%,大肠埃希菌1株,占11.1%。药敏结果显示对复方新诺明、环丙沙星、哌拉西林/他唑巴坦的敏感率分别为55.7%、11.1%、11.1%,患者病情凶险,临床预后较差。结论 为某医院多重耐药菌的预防控制,以及合理使用抗生素提供依据。     

铜绿假单胞菌ESBLs和AmpC酶的检测及耐药性分析

目的了解铜绿假单胞菌临床分离株ESBLs和AmpC酶的产生及对常用抗菌药物敏感性,指导临床合理选用抗生素。方法常规培养分离细菌,采用VITEK-60型全自动细菌鉴定仪鉴定细菌;按NCCLS推荐的双纸片确证法和K-B纸片扩散法检测ESBLs和药敏试验;采用头孢西丁纸片扩散法筛选疑产AmpC酶阳性菌株,确诊采用三维试验。结果铜绿假单胞菌产ESBLs和AmpC酶总检出率分别为40.8%和38.2%,其中,单产AmpC酶、单产ESBLs和同产AmpC酶+ESBLs检出率分别为19.7%、26.3%和14.5%。药敏试验显示:产酶株的耐药性明显高于非产酶株,耐药现象在同产AmpC酶和ESBLs菌株中更为严重。结论台州地区临床分离的铜绿假单胞菌产ESBLs和AmpC酶菌株检出率较高。产AmpC酶和ESBLs的菌株呈高度耐药,临床上对产酶菌株引起感染的治疗应根据细菌药敏试验结果,合理选择有效的抗菌药物联合治疗,减少产酶菌株的产生和流行。     

福建某基层医院CRE碳青霉烯类耐药基因分析

目的对福建省南平市第二医院分离的碳青霉烯类耐药肠杆菌科细菌进行碳青霉烯类基因和其他β内酰胺类耐药基因检测。方法收集碳青霉烯类耐药肠杆菌科细菌,采用Vitek-2 Compact全自动细菌鉴定/药敏仪器进行细菌鉴定和药敏试验;采用改良Hodge试验对实验菌株进行表型检测;利用PCR及测序法对常见的碳青霉烯类和β-内酰胺类耐药基因进行检测;质粒接合试验检测碳青霉烯类耐药基因是否具有可转移性。结果共收集到4株碳青霉烯类耐药肠杆菌科细菌,呈多重耐药性。2株改良Hodge试验阳性。试验菌株均检出碳青霉烯类耐药基因(NDM-1、IMP-8或VIM-2),并同时携带有其他β内酰胺类基因;4株细菌中有3株的碳青霉烯类耐药基因接合成功。结论碳青霉烯类耐药肠杆菌科细菌已在福建基层医院出现,并具有一定传播性,应引起相关主管部门的注意,以防耐药菌的流行。     

908株烧伤患者病原菌分布特征及耐药性分析

目的：了解本院2011 年-2013 年烧伤患者分离病原菌的分布特征及耐药性,为合理使用抗生素提供依据。方法：对患者创面 分泌物、痰液、血液中的细菌进行分离鉴定和药敏试验,药敏数据分析用WHONET5.6 软件。结果：共分离908 株病原菌,其中最 常见的病原菌依次为：鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、表皮葡萄球菌、金黄色葡萄球菌、大肠埃希菌。在革兰阴性杆 菌中,鲍曼不动杆菌对碳青霉烯类耐药率较高,铜绿假单胞菌对氨基糖苷类、喹诺酮类的耐药率较低。在肠杆菌科细菌中,未发现 耐碳青霉烯类大肠埃希菌和肺炎克雷伯菌株。在葡萄球菌中,未发现耐万古霉素、利奈唑胺菌株。结论：我院烧伤患者分离的病原 菌以非发酵菌为主,医院应重视对其病原菌耐药性监测,指导临床合理使用抗生素。     

圈养大熊猫肠道微生物分离、鉴定及细菌耐药性研究

对中国卧龙自然保护区大熊猫研究中心-碧峰峡基地64只大熊猫分别采取粪样,用选择性培养基分离大肠杆菌、沙门氏菌,根据形态特征及16S rDNA序列对菌株进行鉴定;用PDA培养基分离真菌,真菌通用引物ITS4、ITS5进行扩增鉴定。采用K-B法(CLSI)药敏试验测试大肠杆菌和沙门氏菌对18种药敏纸片的耐药性。形态学与rDNA-ITS序列鉴定表明,共分离到真菌19株,鉴定为8个属。分离出大肠杆菌88株,沙门氏菌47株;大肠杆菌对各抗生素的耐药率为0%~35.22%,耐药率为TET(35.22%)、AML(12.50%)、S3(12.50%),共产生17种耐药谱,其中TET、AML-TET谱型占优势;沙门氏菌对各抗生素的耐药率为0%~42.55%,耐药率为TET(42.55%)、AML(40.43%)、S3(38.30%),也产生了17种耐药谱,AML和AML-TET谱型占优势。通过对细菌和真菌的分离鉴定以及细菌的耐药性试验,了解大熊猫肠道微生物与不同个体的关系,为研究大熊猫的营养及消化等奠定基础,对预防和诊断大熊猫肠道疾病,提高大熊猫的存活率提供依据。     

社区与医院感染中肺炎克雷伯杆菌和大肠埃希菌耐药性分析

目的探讨社区和医院感染中肺炎克雷伯杆菌和大肠埃希菌产ESBLs的情况及耐药特性。方法采用体外扩散确证试验检测ESBLs,同时用Micro scan wat RA way-40系统全自动细菌鉴定/药敏分析仪及K-B琼脂扩散法进行细菌鉴定和体外药敏试验。结果社区感染标本中分离出肺炎克雷伯杆菌79株,产ESBLs20株,阳性率为25.3%,大肠埃希菌177株,产ESBLs27株,阳性率为15.3%;医院感染标本中分离出肺炎克雷伯杆菌82株,产ES-BLs33株,阳性率为40.2%,大肠埃希菌135株,产ESBLs42株,阳性率为31.1%,社区与医院感染菌株产ESBLs比较差异均有统计学意义(P均<0.05);ESBLs阳性菌株对多种抗生素耐药,其耐药性明显高于ESBLs阴性菌株。结论肺炎克雷伯杆菌和大肠埃希菌产ESBLs菌株在临床分离率较高,医院感染标本要显著高于社区感染标本,并且对多种抗生素具有高度耐药性,产ESBLs菌株耐药性显著高于不产ESBLs菌株,临床上应加强对ESBLs的控制,以防感染流行。     

MHT和mCIM试验检测肠杆菌科金属碳青霉烯酶效能的评价

目的探讨改良Hodge试验(MHT)及改良碳青霉烯灭活试验(mCIM)检测肠杆菌科细菌金属碳青霉烯酶的应用价值。方法 VITEK 2Compact全自动细菌鉴定及药敏系统进行细菌鉴定和药敏试验,筛选2015-2017年非重复临床分离的碳青霉烯类耐药的肠杆菌科细菌,MHT及mCIM进行产碳青霉烯酶表型确证试验,PCR检测常见的金属碳青霉烯酶IMP-4、IMP-8、VIM-1、VIM-2、NDM基因。比较MHT及mCIM对肠杆菌科金属碳青霉烯酶的检测效能。结果本实验共收集40株临床分离菌株,MHT阳性36株,阳性率90.0%。mCIM阳性39株,阳性率为97.5%。PCR产物测序Blast比对证实4株为产IMP酶菌株,5株产NDM型菌株,未检测到VIM基因。MHT试验检测IMP酶的灵敏度、特异性、阳性预测值、阴性预测值分别为100.0%、11.1%、11.1%、100.0%,MHT检测NDM酶分别为40.0%、2.9%、5.6%、25.0%。mCIM检测IMP酶的灵敏度、特异性、阳性预测值、阴性预测值分别100.0%、2.8%、10.3%、100.0%,mCIM检测NDM型分别为100.0%、2.9%、12.8%、100.0%。结论 MHT及mCIM检测肠杆菌科细菌产金属碳青霉烯酶具有良好的灵敏度,但特异性偏低,应结合分子生物学方法进行检测,为感染控制提供保障。     

猪源绿色气球菌的分离鉴定与药敏特性研究

目的鉴定研究2006年和2008年本实验室分别从广东清远和广西北流两个猪场发病小猪的膝关节积液中分离到2株呈四联状或成对排列,在山羊血琼脂平板上能形成明显的α-溶血圈的G+球菌。方法采用小白鼠致病性试验、细菌常规生理生化鉴定、药敏试验、耐药基因检测及16S rRNA序列分析等方法对上述分离的2株细菌进行鉴定及药敏特性研究。结果确定这2株G+球菌为正常情况下非致病性绿色气球菌(登录号分别为:GQ161096;GQ161097)。系统发育分析表明,两分离株与绿色气球菌15MS(登录号:EU075039.1)同源性分别高达99.4%和98.7%。药敏试验及耐药基因检测发现,这2株绿色气球菌除了对新霉素、氟哌酸、恩诺沙星、菌必治和环丙沙星等5种药物呈高敏外,对先锋V等13种抗菌素均不敏感。耐药基因检测结果表明,GXBL-1可检出6个耐药基因,GDQY-1则可检出多达10个耐药基因。结论从这2株分离株耐药谱检测结果可以看出,正常菌株同样携带多重耐药基因,存在着通过质粒转座子和整合子将耐药基因转移给敏感菌,导致耐药性传播的可能,应引起足够重视。     

372株溶血葡萄球菌的临床分布及耐药性

目的了解医院4年来溶血葡萄球菌的临床分布特征及耐药性变化,为临床合理用药提供参考依据。方法回顾性分析2010年1月至2013年12月住院患者标本分离的372株溶血葡萄球菌,采用美国BD Phoenix 100全自动细菌鉴定药敏分析仪及其配套GP检测卡进行药敏分析。结果分离的372株溶血葡萄球菌主要分布于ICU、呼吸内科和外科,主要来源于痰液、尿液和伤口分泌物;未检测到万古霉素耐药菌株,对阿莫西林/克拉维酸、氨苄西林、苯唑西林、红霉素、青霉素、头孢西丁均保持90%以上的高耐药性,对其它抗生素均存在不同程度耐药性。结论溶血葡萄球菌耐药现象日益严重,且多重耐药现象呈上升趋势,临床在治疗此类细菌感染时,应根据药敏试验结果制定用药方案,减少经验用药。     

Limited Bacterial Diversity within a Treatment Plant Receiving Antibiotic-Containing Waste from Bulk Drug Production

Biological treatment of waste water from bulk drug production, contaminated with high levels of fluoroquinolone antibiotics, can lead to massive enrichment of antibiotic resistant bacteria, resistance genes and associated mobile elements, as previously shown. Such strong selection may be boosted by the use of activated sludge (AS) technology, where microbes that are able to thrive on the chemicals within the wastewater are reintroduced at an earlier stage of the process to further enhance degradation of incoming chemicals. The microbial community structure within such a treatment plant is, however, largely unclear. In this study, Illumina-based 16S rRNA amplicon sequencing was applied to investigate the bacterial communities of different stages from an Indian treatment plant operated by Patancheru Environment Technology Limited (PETL) in Hyderabad, India. The plant receives waste water with high levels of fluoroquinolones and applies AS technology. A total of 1,019,400 sequences from samples of different stages of the treatment process were analyzed. In total 202, 303, 732, 652, 947 and 864 operational taxonomic units (OTUs) were obtained at 3% distance cutoff in the equilibrator, aeration tanks 1 and 2, settling tank, secondary sludge and old sludge samples from PETL, respectively. Proteobacteria was the most dominant phyla in all samples with Gammaproteobacteria and Betaproteobacteria being the dominant classes. Alcaligenaceae and Pseudomonadaceae, bacterial families from PETL previously reported to be highly multidrug resistant, were the dominant families in aeration tank samples. Despite regular addition of human sewage (approximately 20%) to uphold microbial activity, the bacterial diversity within aeration tanks from PETL was considerably lower than corresponding samples from seven, regular municipal waste water treatment plants. The strong selection pressure from antibiotics present may be one important factor in structuring the microbial community in PETL, which may affect not only resistance promotion but also general efficiency of the waste treatment process.     

The role of mechanically purified city sewers in the spread of antibiotic-resistant bacteria of the Enterobacteriaceae family

The aim of this study was to evaluate a degree of contribution of mechanically cleansed municipal sewage in a spread in on environment of bacteria of Enterobacteriaceae family with special regard to antibiotic resistant strains. High number of bacteria of Enterobacteriaceae family was found in 1 ml of sewage and the number of antibiotic-resistant bacteria was 0.5-50 X 10(3)/ml. Among the strains tested the resistance to more than one antibiotics was encountered. 78.3% of strains transferred antibiotic resistance to E. coli recipient strain, what indicate a participation of potentially pathogenic bacteria from Enterobacteriaceae family in a spread of antibiotic resistance in a environment.     

Horizontal transfer of antibiotic resistance genes in a membrane bioreactor

Growing attention has been paid to the dissemination of antibiotic resistance genes (ARGs) in wastewater microbial communities. The application of membrane bioreactors (MBRs) in wastewater treatment is becoming increasingly widespread. We hypothesized that the transfer of ARGs among bacteria could occur in MBRs, which combine a high density of bacterial cells, biofilms, and antibiotic resistance bacteria or ARGs. In this study, the transfer discipline and dissemination of the RP4 plasmid in MBRs were investigated by the counting plate method, the MIDI microorganism identification system, and quantitative polymerase chain reaction (qPCR) techniques. The results showed that the average transfer frequency of the RP4 plasmid from the donor strain to cultivable bacteria in activated sludge was 2.76 × 10⁻⁵ per recipient, which was greater than the transfer frequency in wastewater and bacterial sludge reported previously. In addition, many bacterial species in the activated sludge had received RP4 by horizontal transfer, while the genera of Shewanella spp., Photobacterium spp., Pseudomonas spp., Proteus spp., and Vibrio spp. were more likely to acquire this plasmid. Interestingly, the abundance of the RP4 plasmid in total DNA remained at high levels and relatively stable at 10⁴ copies/mg of biosolids, suggesting that ARGs were transferred from donor strains to activated sludge bacteria in our study. Thus, the presence of ARGs in sewage sludge poses a potential health threat.     

Antibiotic resistance of bacteria in raw and biologically treated sewage and in groundwater below leaking sewers

More than 750 isolates of faecal coliforms (>200 strains), enterococci (>200 strains) and pseudomonads (>340 strains) from three wastewater treatment plants (WTPs) and from four groundwater wells in the vicinity of leaking sewers were tested for resistance against 14 antibiotics. Most, or at least some, strains of the three bacterial groups, isolated from raw or treated sewage of the three WTPs, were resistant against penicillin G, ampicillin, vancomycin, erythromycin, triple sulfa and trimethoprim/sulfamethoxazole (SXT). Only a few strains of pseudomonads or faecal coliforms were resistant against some of the other tested antibiotics. The antibiotic resistances of pseudomonads, faecal coliforms and enterococci from groundwater varied to a higher extent. In contrast to the faecal coliforms and enterococci, most pseudomonads from all groundwater samples, including those from non-polluted groundwater, were additionally resistant against chloramphenicol and SXT. Pseudomonads from sewage and groundwater had more multiple antibiotic resistances than the faecal coliforms or the enterococci, and many pseudomonads from groundwater were resistant to more antibiotics than those from sewage. The pseudomonads from non-polluted groundwater were the most resistant isolates of all. The few surviving faecal coliforms in groundwater seemed to gain multiple antibiotic resistances, whereas the enterococci lost antibiotic resistances. Pseudomonads, and presumably, other autochthonous soil or groundwater bacteria, such as antibiotic-producing Actinomyces sp., seem to contribute significantly to the gene pool for acquisition of resistances against antibiotics in these environments.     

土霉素暴露对小麦根际抗生素抗性细菌及土壤酶活性的影响

通过培养的方法研究了土霉素暴露和小麦根际抗性细菌的数量、种类、分布特征及土壤酶活性之间的剂量效应关系。结果表明,土霉素暴露下小麦根际单一抗生素抗性细菌数量和抗土霉素—链霉素双重抗性细菌数都明显增加,且与暴露剂量呈正效应关系;同时,土壤磷酸酶、脱氢酶活性下降,但与土霉素的剂量效应关系不明显。从土霉素暴露的土壤中分离到50株抗性细菌,经形态观察、RFLP分组和16S rDNA序列测定与分析,将它们聚集在Actinobacteria、Bacilli、Alphaproteobacteria、Gammaproteobacteria 和Sphingobacteria类群。其中放线菌最多（15株）,占抗性菌总数的30 %;其次是Bacillus属细菌（9株）和Pseudomonas属细菌（8株）,分别占18 %和16 %。同时,具有抗性的人类机会致病菌Pseudomonas、Sphingomonas和Stenotrophomonas属细菌在土霉素暴露的样品中均被分离到,分别占抗性菌株总数的16 %、8 %和4 %。值得注意的是,随着土霉素暴露剂量的增加,小麦根际优势促生菌Bacillus属细菌的抗性检出率逐步降低;但具有抗生素抗性的人类机会致病菌Pseudomonas、Sphingomonas和Stenotrophomonas属细菌的检出率却明显增加,提示可能会进一步增大其机会致病性。     

医院血培养的病原菌分布及耐药性分析

目的 了解我院2006年至2008年血培养中病原菌的阳性率、分布及其对药物的敏感情况,为临床治疗菌血症提供用药依据.方法 采用自动血培养仪对血培养瓶进行连续培养监测,全自动微生物分析系统对血标本中分离的病原菌进行鉴定和药物敏感试验.结果 1002份血培养标本分离出病原菌103株,阳性率10.3%,其中革兰阴性菌58株,占56.3%;革兰阳性菌32株,占31.9%;真菌10株,占9.7%.革兰阴性菌中,大肠埃希菌、肺炎克雷伯菌对氨苄西林的耐药率最高,分别为92.7%和92.3%.革兰阳性菌中,金黄色葡萄球菌、凝固酶阴性葡萄球菌对青霉素耐药率达100%,肠球菌对常用抗生素呈高度耐药,未发现葡萄球菌对万古霉素耐药,但有9.1%的肠球菌对万古霉素呈中介.结论 目前我院血培养分离的病原菌分布较广,大肠埃希菌和葡萄球菌是菌血症和(或)败血症的主要病原菌;药敏结果提示检出菌耐药性严重且广谱耐药,及时准确的血培养结果能为临床合理选择抗菌药物提供重要依据.     

Fecal coliforms of wastewater treatment plants: antibiotic resistance, survival on surfaces and inhibition by sodium chloride and ascorbic acid.

Three hundred and sixteen fecal coliform strains isolated from raw sewage and final effluents of two representative wastewater treatment plants were examined for antibiotic resistance. For plant A (which was disinfecting its effluents before discharge), 55% and 41% of the strains isolated from the influent and the effluent, respectively were resistant to one or more antibiotics. For plant B (which was not disinfecting its effluents before discharge), 33% and 58% of the strains isolated from the influent and the effluent, respectively were resistant to one or more antibiotics. A considerable proportion of these bacteria were resistant to three or more antibiotics. NaCl (3%) and ascorbic acid (0.1%) reduced the growth rate of both sensitive and resistant strains, and more inhibitory effects on the sensitive strains than on the resistant strains were observed. All resistant strains tested survived on various types of surfaces (e.g. glass, stainless steel, agar, cabbage, parsley and sand) significantly better than sensitive strains.     

Resistance to antibacterial drugs of Enterobacteriaceae isolated from healthy children and from those with Salmonella infections

A total of 2329 Enterobacteriaceae strains in bacterial associations isolated from healthy children and children with salmonellosis were tested for their resistance to antimicrobial drugs. It was shown that the aerobic microbial associations isolated from the healthy children contained higher numbers of strains sensitive or resistant to 1-3 antibiotics while the microbial associations from the children patients with salmonellosis treated with antibiotics contained higher numbers of strains resistant to 6-8 antibiotics. Resistance of the aerobic bacterial associations was mainly defined by resistance of E. coli and K. pneumoniae. The feces of the healthy children never treated with antimicrobial drugs contained strains resistant to them. The use of the antibiotics in the treatment led to increasing numbers of the resistant bacteria and changing species composition of the bacterial associations.     

The composition and persistence of faecal coliforms and enterococcal populations in sewage treatment plants

AIMS: The changes in structure and composition of faecal coliforms and enterococcal populations in sewage from different treatment plants, and the elimination of vancomycin- and erythromycin-resistant enterococci (VRE and ERE, respectively) in these treatment plants was analysed to determine any selective reduction. METHODS AND RESULTS: Faecal coliforms, enterococci, VRE, ERE and spores of sulphite-reducing bacteria were enumerated using standard methods. Samples were enriched where necessary in order to isolate antibiotic resistant strains. The structure and composition of these bacterial populations were determined by biochemical fingerprinting and clustering analysis. High diversity and similarity indexes were detected among all the bacterial populations in raw and treated sewage, independently of their origin and the treatment processes employed. Antibiotic resistant strains were detected in all sewage tested and no selective reduction was observed. CONCLUSIONS: The faecal coliforms and enterococci populations did not differ in the sewage samples studied. The vancomycin and erythromycin resistances of the enterococcal populations were similar in the sewage samples. Resistance to both antibiotics persisted after the treatment process independently of raw sewage flow, faecal origin or size of the human population contributing to sewage. However, sewage of mixed origin (human and animal) presented a lower similarity index for the two bacterial populations compared with that of the other human sewage analysed. SIGNIFICANCE AND IMPACT OF THE STUDY: Although a significant reduction in bacterial populations was observed, the persistence of VRE and ERE strains in the same proportions in sewage suggests that there is no selective elimination of bacterial populations during the treatment processes. The ability of antibiotic resistance strains to survive sewage treatment systems should be considered in certain water reuse programmes.     

伤口分泌物的病原菌分布及耐药性分析

目的调查福建省龙岩市第二医院伤口分泌物病原菌的分布及耐药情况,为合理应用抗生素提供依据。方法收集2012年1月至2013年5月患者伤口分泌物标本,采用常规方法进行分离培养,用VITEK-2 Compact全自动微生物分析仪系统进行鉴定及药敏分析。结果送检503份标本,培养阳性272份,阳性率为54. 1% ;病原菌检出343株,其中革兰阴性菌189株占55. 1%,革兰阳性菌151株占44.0%,真菌3株占0.9% ;前5位的病原菌分别为金黄色葡萄球菌、凝固酶阴性葡萄球菌、铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌。耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）的检出率分别是30.4%、82. 1%。粪肠球菌中耐高浓度氨基糖苷类肠球菌（HLAR）的检出率为55%。革兰阳性菌对万古霉素、替加环素、利奈唑胺未出现耐药菌株。铜绿假单胞菌、肠杆菌科细菌对亚胺培南的耐药率分别为5. 6%、0。大肠埃希菌中超广谱P-内酰胺酶（ESBL）的检出率是42.9%。鲍曼不动杆菌对头孢哌酮/舒巴坦的耐药率最低为25.0%,对其他抗菌药物耐药严重,多数抗菌药物的耐药率均〉45%。结论伤口感染的主要病原菌是革兰阴性菌,多重耐药菌株比例较高,临床应根据药敏结果合理选用抗生素,减少新的耐药菌株出现。