腹部手术患者腹腔积液分离病原菌特点的临床分析  

Clinical characteristics of pathogens isolated from peritoneal effusions of patients undergoing abdominal surgery

作　　者：贺占国[1] 贾恒川[2] 陈晶[1] 李栋梁[3] 贺政新[1] 刘培红[1] 陈兴[1] 侯天文[1] 

机构地区：[1]白求恩国际和平医院检验科,河北石家庄050082 [2]白求恩国际和平医院医务部,河北石家庄050082 [3]白求恩国际和平医院血液内科,河北石家庄050082

出　　处：《中华医院感染学杂志》2014年第14期3549-3551,共3页Chinese Journal of Nosocomiology

基　　金：河北省自然科学基金项目(C2010001882)

摘　　要：目的了解腹部手术患者发生腹腔感染的病原菌特点、基础疾病和治疗转归,为临床降低术后感染发生率,提高治愈率提供参考依据。方法调查2012年5月1日-2013年4月30日于医院进行腹部外科手术42例患者送检腹腔积液的培养阳性结果。结果共有42例患者发生腹腔感染,基础疾病以腹腔恶性肿瘤多见占45.24%,其次为腹腔炎症占21.43%;分离出病原菌74株,其中革兰阳性球菌占20.27%,革兰阴性杆菌占70.27%,真菌占9.46%,有20例分离出>2种病原菌,占47.62%;病原菌前5位的依次是以大肠埃希菌、肠球菌属、铜绿假单胞菌、鲍氏不动杆菌、假丝酵母菌属,分别占24.32%、14.87%、12.17%、9.46%、9.46%;6例患者死亡,病死率14.29%。结论腹部肿瘤手术患者腹腔感染常见,多由肠道菌群混合感染所致,预后较差。OBJECTIVE To investigate the distribution of pathogens causing abdominal infections in the patients undergoing abdominal surgery and understand the underlying diseases and prognosis so as to reduce the incidence of postoperative infections and raise the cure rate.METHODS Totally 42patients who underwent abdominal surgeries in the hospital from May 1,2012to Apr 30,2013were enrolled in the study,then the results of positive culture of submitted peritoneal effusions were reviewed.RESULTS The abdominal infections occurred in 42patients.Among the patients with underlying disease,the patients with malignant abdominal tumors accounted for45.24%,the patients with peritoneal inflammation 21.43%.A total of 74strains of pathogens have been isolated,among which the gram-positive cocci accounted for 20.27%,the gram-negative bacilli 70.27%,the fungi9.46%;more than 2species of pathogens were isolated from 20（47.62%）patients.The Escherichia coli,Enterococci,Pseudomonas aeruginosa,Acinetobacter baumannii,and Candida rankedthe top five species of pathogens,accounting for 24.32%,14.87%,12.17%,9.46%,and 9.46%,respectively.6case died with the mortality rate of 14.29%.CONCLUSION The abdominal infections are common in the patients undergoing abdominal surgeries and are mainly caused by mixed intestinal flora,and the prognosis is poor.

关 键 词：腹部手术 腹腔积液 病原菌 耐药性 

分 类 号：R656[医药卫生—外科学]