普外科患者术后切口感染病原菌与耐药性分析  

Distribution and drug resistance of pathogens causing postoperative incision infections in patients of general surgery department

作　　者：孙晓林[1] 宋展[1] 于桂青[1] 王耿泽[1] 刘延娟[1] 钱国武[1] 

机构地区：[1]南阳市中心医院普外科,河南南阳473009

出　　处：《中华医院感染学杂志》2015年第6期1262-1264,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81272371)

摘　　要：目的了解普外科患者术后切口感染病原菌分布及耐药性,为临床防治提供参考。方法回顾性分析2010年5月-2013年5月4 079例普外科手术患者临床资料,采用全自动细菌鉴定仪中进行病原菌鉴定,以纸片法(K-B)进行药敏试验,数据采用SPSS17.0统计软件进行统计分析。结果术后发生切口感染147例,感染率为3.60%,Ⅰ、Ⅱ、Ⅲ类手术切口感染率分别为1.54%、3.63%、8.55%;送检标本121份,检出病原菌94株,检出阳性率为77.69%,其中革兰阴性菌67.02%、革兰阳性菌32.98%,检出耐甲氧西林金黄色葡萄球菌8株,耐甲氧西林表皮葡萄球菌1株;大肠埃希菌对氨苄西林、头孢唑林、庆大霉素、左氧氟沙星耐药率均>90.00%,肠杆菌属对头孢唑林耐药率为100.00%,肠球菌属对左氧氟沙星、青霉素耐药率均为83.33%,金黄色葡萄球菌对苯唑西林、青霉素、头孢唑林、克林霉素、左氧氟沙星耐药率均>77.00%。结论普外科手术后切口感染病原菌呈现感染病原菌分布多样性,主要以大肠埃希菌及肠球菌属多见,对临床常用抗菌药物的耐药率均较高。OBJECTIVE To understand the distribution and drug resistance of pathogens causing postoperative inci -sion infections in the patients of general surgery department so as to provide guidance for clinical prevention and treatment .METHODS The clinical data of 4 079 patients who underwent surgeries in the general surgery depart-ment from May 2010 to May 2013 were retrospectively analyzed ,the pathogens were identified with the use of au-tomatic bacteria identification system ,the drug susceptibility testing was performed by using disk method （K-B） , and the statistical analysis of the data was carried out by means of SPSS 17 .0 software .RESULTS The postopera-tive incision infections occurred in 147 cases ,with the infection rate of 3 .60% ;the incidence of the incision infec-tions was 1 .54% in the patients undergoing the type Ⅰ incision surgery ,3 .63% in the patients undergoing the type Ⅱ incision surgery ,8 .55% in the patients undergoing the type Ⅲ incision surgery .Totally 94 strains of pathogens were isolated from 121 submitted specimens with the positive isolation rate of 77 .69% ,of which 67 .02% were the gram-negative bacteria and 32 .98% were the gram-positive bacteria .Totally 8 strains of methi-cillin-resistant Staphylococcus aureus and 1 strain of methicillin-resistant Staphylococcus epidermidis were isola-ted .The drug resistance rates of the Escherichia coli to ampicillin ,cefazolin ,gentamicin ,and levofloxacin were more than 90 .00% ;the drug resistance rate of the Enterobacter spp to cefazolin was 100 .00% ;the drug resist-ance rates of the Enterococcus sp p to levofloxacin and penicillin were 83 .33% ;the drug resistance rates of the Staphylococcus aureus to oxacillin ,penicillin ,cefazolin ,clindamycin ,and levofloxacin were more than 77 .00% . CONCLUSION The pathogens causing the postoperative incision infections in the patients of general surgery de-partment are diversified ,among which the E .coli and Enterococcus sp p are dominant ,and the strains are highly resistant to the common

关 键 词：普外科 医院感染 切口感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]