清创后培养中对克雷伯菌的抗生素敏感性——Jember Soebandi医院急诊科开放性骨折

D. Agustina, Endiningtyas Cahyaningrum, Cicih Komariah, I. Semita, Yudha Ananta Khaerul Putra
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引用次数: 0

摘要

开放性骨折的手术部位感染(SSI)通常是由开放性骨折治疗中的细菌污染引起的。正因为如此,处理开放性骨折最重要的事情之一就是清创术。预防性抗生素有头孢菌素和氨基糖苷类。清创术后培养在预测感染发生率方面很重要。在清创术后培养中经常发现的细菌之一是克雷伯菌。它可以产生ESBL来对抗β-内酰胺类抗生素。本研究的目的是确定在Jember Soebandi医生医院急诊科开放性骨折病例的清创术后培养中对克雷伯菌的抗生素敏感性。本研究采用实验室探索性研究设计。本研究的样本是克雷伯氏菌的分离株。2019年3月至5月,在Jember Soebandi医生医院急诊科对开放性骨折患者进行清创术后培养,共分离出5株克雷伯菌。使用的方法是扩散法(Kirby Baurer),通过使用CLSI标准表进行匹配来确定敏感性、中间性或耐药性。本研究结果表明,大多数抗生素对克雷伯菌有耐药性,包括β-内酰胺类抗生素,如阿莫西林、头孢曲松、头孢克肟、青霉素、美罗培南和头孢羟氨苄。万古霉素抗生素对所有患者的克雷伯菌属仍然敏感。1例患者对庆大霉素、环丙沙星、四环素和氯霉素敏感。红霉素是对抗克雷伯菌的中间体。本研究的结论是,所有β-内酰胺类抗生素都对克雷伯杆菌具有耐药性,而最敏感的抗生素是万古霉素。
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Antibiotic Sensitivity Against Klebsiella spp. in the Post Debridement Culture an Open Fracture in Emergency Department of dr. Soebandi Hospital Jember
Surgical site infection (SSI) in open fracture is often caused by bacterial contamination in the management of open fracture. Because of that, one of the most important thing in handling open fracture is debridement. Prophylactic antibiotics given are Cephalosporin and Aminoglycosides. Post-debridement culture is important in predicting the incidence of infection. One of the bacteria that is often found in post-debridement culture is Klebsiella spp. which can produce ESBL to fight β-lactam class of antibiotics. The purpose of this study was to determine antibiotic sensitivity against Klebsiella spp. in the post-debridement culture of cases of open fractures in the emergency department of dr. Soebandi hospital Jember. This study uses a laboratory exploratory research design. The sample of this study was the isolate of Klebsiella spp. which amounts to 5 from post debridement culture of open fracture patients in the emergency department of dr. Soebandi hospital Jember from March to May 2019.The method used is diffusion (Kirby Baurer) by matching using the CLSI standard table to determine sensitive, intermediate, or resistant. The results of this study showed that most antibiotics had resistance to Klebsiella spp., including β-lactam antibiotics, such as Amoxicillin, Ceftriaxone, Cefixime, Penicilin, Meropenem, and Cefadroxil. Vancomycin antibiotics are still sensitive to Klebsiella spp. in all patients. Gentamicin, Ciprofloxacin, Tetracycline, and Chloramphenicol antibiotics were sensitive in 1 patient. Erythromycin intermediates antibiotics against Klebsiella spp.. The conclusion of this study is that all β-lactam group antibiotics are resistant to Klebsiella spp while the most sensitive antibiotic is Vancomycin.
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