泌尿外科患者手术切口感染的病原菌分布特点及对策  

Distribution of pathogens causing surgical incision infections in urologic surgery department and countermeasures

作　　者：刘昌茂[1,2] 张琼[1,2] 

机构地区：[1]荆州市第一人民医院 [2]长江大学附属第一医院泌尿外科,湖北荆州434000

出　　处：《中华医院感染学杂志》2013年第9期2224-2226,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨泌尿外科患者发生手术切口感染的病原学分布特点及对策,为临床治疗及合理用药提供依据。方法选取2006年2月-2012年2月在医院行泌尿外科手术后发生手术切口感染的患者89例为研究对象,对其病原学分布特点进行统计分析。结果经病原学检测共分离病原菌121株,前5位菌株依次为甲氧西林敏感金黄色葡萄球菌(MSSA)、大肠埃希菌、肠球菌属、铜绿假单胞菌、肺炎克雷伯菌分别占26.4%、14.0%、12.4%、9.1%、8.3%;肺炎克雷伯菌对亚胺培南的耐药率为0、大肠埃希菌、不动杆菌属、铜绿假单胞菌对亚胺培南的耐药率分别为5.9%、16.7%、9.1%;肠球菌属对苯唑西林的耐药率为11.8%,MSSA、甲氧西林金黄色葡萄球菌(MRSA)、甲氧西林敏感凝固酶阴性葡萄球菌(MSCNS)对万古霉素的耐药率均为0,明显低于其他药物的耐药率(P<0.05)。结论泌尿外科术后患者手术切口感染的病原菌主要为MSSA,在病原菌培养及药敏试验结果报告之前,可根据伤口感染的情况大致判断感染病原菌类型,同时根据药敏结果选择相应抗菌药物进行经验性抗感染治疗。OBJECTIVE To discuss the characteristics of pathogens distribution and the countermeasures for the surgical incision infections in the urologic surgery department so as to provide basis for the clinical treatment and the reasonable use of antibiotics.METHODS From Feb,2006 to Feb,2012,totally 89 patients who were with the surgical incision infection after the urologic surgery were selected as the study objects,and the statistical analysis of the distribution of the pathogens was performed.RESULTS Through the pathological detection,a total of 121 strains of pathogens were isolated,the top five species were in turn as follows： methicillin-sensitive Staphylococcus aureus（26.4%）,Escherichia coli（14.0%）,Enterococci（12.4%）,Pseudomonas aeruginosa（9.1%）,and Klebsiella pneumoniae（8.3%）.The drug resistance rate of the K.pneumoniae to imipenem was 0%,the drug resistance rates of E.coli,Acinetobacter spp,and P.aeruginosa to imipenem were 5.9%,16.7%,and 9.1%,the drug resistance rate of Enterococci to oxacillin was 11.8%,the drug resistance rate of MSSA,MRSA,and methicillin-sensitive coagulase-negative Staphylococci to vancomycin were 0,significantly lower than that to other antibiotics（P0.05）.CONCLUSION MSSA is dominant in the pathogens causing surgical incision infections after the urologic surgery.The species of the pathogens can be roughly determined on the basis of the wound infections before the bacterial culture and the drug susceptibility testing,meanwhile,it is necessary to choose appropriate antibiotics for the anti-infection therapy based on the result of the drug susceptibility testing.

关 键 词：泌尿外科 手术切口感染 病原学分布 

分 类 号：R378[医药卫生—病原生物学]