胃造口周围皮下感染患者病原菌分析与预防  

Analysis and prevention of pathogenic bacteria in patients with peripheral subcutaneous infections after gastrostomy

作　　者：陈秀荣[1] 彭宗银[1] 龙国利[1] 陈超华[1] 白兰燕 

机构地区：[1]四川省人民医院城东病区ICU,四川成都610110

出　　处：《中华医院感染学杂志》2016年第5期1081-1083,共3页Chinese Journal of Nosocomiology

基　　金：四川省卫生厅科研基金资助项目(120136)

摘　　要：目的分析胃造口周围皮下感染患者的病原菌分布及耐药菌,进行相应的护理预防措施,降低胃造口周围皮下感染率。方法选择2010年5月-2015年5月在医院行胃造口术发生周围皮下感染的300例患者,采用法国生物梅里埃公司VITEK-2Compact细菌鉴定进行细菌鉴定,药物敏感试验采用K-B法;分析患者的病原菌分布和耐药性,采用SPSS16.0统计软件对数据进行统计分析。结果共检出病原菌300株,其中金黄色葡萄球菌81株占27.0%,溶血性链球菌60株占20.0%,革兰阴性菌中大肠埃希菌对氨苄西林、头孢唑林的耐药率>50.0%,肺炎克雷伯菌对氨苄西林、头孢唑林的耐药率>70.0,铜绿假单胞菌对氨苄西林以及头孢唑林的耐药率>60.0%;革兰阳性菌中葡萄球菌属对青霉素、红霉素的耐药率均最高,>70.0%,溶血性链球菌对红霉素、阿奇霉素的耐药率均最高,均为75.0%,肠球菌属对青霉素、氯霉素、阿奇霉素以及万古霉素的耐药率均较低,尤其是阿奇霉素,耐药率为0。结论金黄色葡萄球菌与溶血性链球菌检出率最高,需根据病原菌的药敏,合理应用抗菌药物,对感染患者进行针对性的护理干预,能够有效降低感染状况的发生。OBJECTIVE To analyze the distribution situation of pathogens and drug-resistant strains in patients with peripheral subcutaneous infections after gastrostomy and conduct the corresponding appropriate care and preventive measures to reduce the peripheral subcutaneous infection rate.METHODS Totally 300 patients who had peripheral subcutaneous infections after gastrostomy during May 2010-May 2015 were selected.The VITEK-2Compact system from BioMerieux Co.Ltd.was used for strain identification and the K-B method was used for drug sensitivity test.The pathogen distribution and the drug resistance situation were analyzed and the software SPSS16.0 was used for statistical analysis.RESULTS A total of 300 pathogens were detected,including 81（27.0%）Staphylococcus aureus and 60（20.0%）Streptococcus hemolytic.Among gram-negative bacteria,the resistance rate to ampicillin and cefazolin was 〉50.0%for Escherichia coli, 〉70.0%for Klebsiella pneumoniae and 〉60.0% for Pseudomonas aeruginosa.Among gram-positive bacteria,S.aureus and coagulase-negative Staphylococci had the highest resistance rate of more than 70.0% to penicillin and erythromycin,hemolytic Streptococcus had the highest resistance rate of 75.0% to erythromycin and azithromycin,Enterococcus had relatively low resistance to penicillin,chloramphenicol,azithromycin and vancomycin,especially to azithromycin with a resistance rate of 0.CONCLUSION S.aureus and hemolytic Streptococcus occupied the highest proportion.Clinicians should perform rational use of antimicrobial drugs based on sensitivity of pathogens and conduct targeted interventions for infected patients so as to effectively reduce the incidence of infections.

关 键 词：胃造口 周围皮下感染 耐药性 预防对策 

分 类 号：R656.61[医药卫生—外科学]