胃肠外科手术患者切口感染病原菌分布与耐药性分析  

Analysis on distribution and drug resistance of pathogenic bacteria of incision infections after gastrointestinal surgery

作　　者：高春玲[1] 张珊珊[1] 吕聚娜 

机构地区：[1]平顶山市第一人民医院胃肠外科,河南平顶山467000

出　　处：《中华医院感染学杂志》2015年第16期3692-3694,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81272371)

摘　　要：目的探讨胃肠外科手术患者切口感染的病原菌分布特点、耐药性分析及预防控制对策,为降低切口感染的发生提供参考依据。方法选取2013年1-12月93例胃肠外科手术后切口感染患者为研究对象,对其切口分泌物及深部分泌物进行病原菌培养及药敏试验,分析结果,数据采用SPSS17.0软件进行统计分析。结果 93例手术患者发生切口感染以阑尾切除术感染率最高,为90.70%,患者送检标本共分离出病原菌91株,检出革兰阴性菌、革兰阳性菌分别占63.74%、36.26%;大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌对头孢菌素类及喹诺酮类等多数抗菌药物耐药率较高,均>50.00%,金黄色葡萄球菌对头孢他啶、头孢唑林、左氧氟沙星等耐药率较高,均>50.00%,粪肠球菌对多数头孢菌素类抗菌药物耐药率较高,均>50.00%。结论胃肠外科手术切口感染病原菌以大肠埃希菌为主,阑尾切除术后更容易发生切口感染,感染病原菌对头孢菌素类及喹诺酮类抗菌药物耐药率较高,在进行手术时合理采取预防措施,以降低切口感染的发生。OBJECTIVE To investigate the distribution characteristics and drug resistance of pathogenic bacteria of incision infections after gastrointestinal surgery and the prevention and control countermeasures ,so as to provide references for reducing incision infections .METHODS Totally 93 patients who had incision infections after gastro‐intestinal surgery were selected as the research subjects .Their incision secretion and deep discharges were ana‐lyzed with pathogenic bacteria culture and drug sensitive test ,the results were statistically analyzed by the soft‐ware SPSS17 .0 .RESULTS Of 93 cases ,the highest rate of incision infections was found in those who had appen‐dectomy ,accounting for 90 .70% .Totally 91 strains of pathogenic bacteria were isolated from the inspected speci‐mens ,including gram‐negative bacteria and gram‐positive bacteria accounting for 63 .74% and 36 .26% . Esche‐richia coli ,Pseudomonas aeruginosa ,and K lebsiella pneumoniae had high resistance of ＆gt;50 .00% to most cepha‐losporins and quinolones .Staphylococcus aureus had high resistance of ＆gt;50 .00% to ceftazidime ,cefazolin ,and levofloxacinover .Enterococcus f aecalis had high resistance of ＆gt;50 .00% to most cephalosporins .CONCLUSION Pathogenic bacteria of incision infections after gastrointestinal surgery are mainly E .coli ,incision infection is more likely to happen after appendectomy .Pathogenic bacteria have higher resistance to cephalosporins and quinolones . Clinicians should take reasonable preventive measures during surgery to reduce incision infection .

关 键 词：胃肠外科 切口感染 病原菌 耐药性 预防控制 

分 类 号：R378[医药卫生—病原生物学]