中文摘要：

目的：探讨骨科无菌手术切口感染的病原菌类型及耐药性，术后切口感染危险因素，为降低骨科手术切口感染提供依据。方法回顾性分析2011年1月－2014年12月800例行骨科无菌手术患者临床资料，分析患者切口感染病原菌类型、主要病原菌耐药性，切口感染危险因素进行单因素方差分析。结果800例行骨科无菌手术患者术后发生感染30例，感染率为3．75％；共分离出病原菌33株，其中革兰阳性菌10株占30．31％，革兰阴性菌22株占66．66％，真菌1株占3．03％，大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌对美罗培南、亚胺培南、哌拉西林、氨曲南的耐药率较低，耐药率均＜50．00％，金黄色葡萄球菌、表皮葡萄球菌对万古霉素、替考拉宁、利福平的耐药率均为0；年龄＞60岁、手术时间＞3 h、接台手术、Ⅲ类切口、植入物、伴有糖尿病是行骨科无菌手术患者术后发生医院感染的危险因素（P＜0．05）。结论骨科无菌手术切口感染病原菌种类较多，感染率较高，耐药性及感染危险因素复杂，应针对感染危险因素采取有效措施，以控制切口感染率。

英文摘要：

OBJECTIVE To explore the distribution and drug resistance of the pathogens causing incision infections in the orthopedics department patients undergoing sterile surgery and analyze the risk factors for the postoperative incision infections so as to reduce the incidence of surgical incision infections in the orthopedics department patients .METHODS The clinical data of 800 orthopedics department patients who underwent the sterile surgery from Jan 2011 to Dec 2014 were retrospectively analyzed ,then the distribution of the pathogens causing incision infections and drug resistance of the major pathogens were analyzed ,and the univariate variance analysis was performed for the risk factors for the incision infections .RESULTS The infections occurred in 30 of 800 orthopedics department patients after the sterile surgery ,with the infection rate of 3 .75% .A total of 33 strains of pathogens have been isolated ,including 10 （30 .31% ） strains of gram‐positive bacteria ,22 （66 .66% ） strains of gram‐negative bacteria ,and 1 （3 .03% ） strain of fungus .The drug resistance rates of the Escherichia coili , Pseudo‐monas aeruginosa ,Klebsiella pneumoniae ,and Acinetobacter baumannii to meropenem ,imipenem ,piperacillin , and aztreonam were less than 50 .00% .The drug resistance rates of the Staphylococcus aureus and Staphylococcus epidermidis to vancomycin ,teicoplanin ,and rifampicin were 0 .The risk factors for the postoperative nosocomial infections in the orthopedics department patients undergoing the sterile surgery included the more than 60 years of age ,operation duration more than 3 hours ,consecutive surgery ,type Ⅲ incision ,implant ,and complication of diabetic mellitus （P〈 0 .05） .CONCLUSION There are a variety of species of pathogens causing the incision infections in the orthopedics department patients undergoing the sterile surgery ,the infection rate is high ,and the drug resistance and the risk factors for the infections are complicated .It is necessary to take effective measures aim