肝胆外科手术后感染的病原菌分布及耐药性分析  

Pathogens causing infections after hepatobiliary surgery and analysis of drug resistance

作　　者：陈浩然[1] 

机构地区：[1]杭州市第三人民医院外科,浙江杭州310009

出　　处：《中华医院感染学杂志》2013年第6期1343-1345,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析肝胆外科手术后感染的病原菌种类及其耐药性,以指导临床有效治疗术后感染。方法选取肝胆外科56例术后感染患者为研究对象,将送检标本进行分离培养,然后进行药敏试验分析病原菌的耐药率。结果分离出68株病原菌,标本来源构成以胆汁、血液、脓液及分泌物为主,分别占23.53%、20.59%、14.70%、10.29%,其中革兰阳性菌24株占35.29%,革兰阴性菌44株占64.71%;主要革兰阳性菌为金黄色葡萄球菌、溶血葡萄球菌、表皮葡萄球菌,分别占14.71%、10.29%、5.88%,主要革兰阴性菌为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和阴沟肠杆菌,分别占20.59%、17.65%、16.18%、10.29%;革兰阳性菌对替考拉宁和利奈唑胺的耐药率较低,革兰阴性菌对妥布霉素、阿米卡星、亚胺培南和美罗培南的耐药率较低。结论治疗过程中医护人员应严格无菌操作,一旦感染应选择耐药率低的抗菌药物及时治疗。OBJECTIVE To analyze the species and the drug resistance of the pathogenic bacteria causing infections after the hepatobiliary surgery so as to guide the effective clinical treatment of the postoperative infections. METHODS A total of 56 cases of patients undergoing the hepatobiliary surgery were selected as the study objects, the submitted specimens were isolated and cultured,and the drug resistance rates of the pathogens were analyzed through the drug susceptibility testing. RESULTS A total of 68 strains of pathogenic bacteria were isolated, the bile, blood, pus, and secretions were the main specimen sources where the pathogens were isolated, accounting for 23.53%, 20. 59%, 14. 70%, and 10. 29%, respectively. Among all the pathogens isolated, there were 24 （ 35.29 %） strains of gram-positive bacteria and 44 （64.71%） strains of gram-negative bacteria. Staphylococcus aureus, Staphylococcus haemolyticus, and Staphylococcus epidermidis were the main gram-positive bacteria, accounting for 14. 71%, 10. 29%, and 5. 88%, respectively. Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterobacter cloacae were the main gram-negative bacteria, accounting for 20.59 %, 17.65%, 16.18%, and 10. 29%, respectively. The drug resistance rates of the gram-positive bacteria to imipenem and linezolid were low, and the drug resistance rates of the gram-negative bacteria to tobramycin, amikacin, imipenem and meropenem were relatively low. CONCLUSION It is necessary for the medical staff to implement the aseptic operation strictly during the treatment, once the infections occurs, the susceptible antibiotics should he selected for the treatment.

关 键 词：肝胆外科 感染 病原菌 耐药率 

分 类 号：R619.3[医药卫生—外科学]