多药耐药菌阴道定植与产妇切口感染相关因素分析  

Related factors for vaginal colonization of multidrug-resistant organisms and incision infections in puerpera

作　　者：范成姣[1] 李静[1] 鲁爱枝[1] 金红梅[1] 漆颖[1] 

机构地区：[1]麻城市人民医院妇产科,湖北麻城438300

出　　处：《中华医院感染学杂志》2016年第5期1121-1123,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅青年科技人才基金资助项目(QJX2012-13)

摘　　要：目的探讨多药耐药菌阴道定植与产妇切口感染相关因素,为临床防治提供参考依据。方法选取2012年8月-2014年3月住院的230例待产妇为研究对象,采集待产妇阴道分泌物标本,同时采用ATB细菌鉴定系统对待产妇阴道的正常菌和多药耐药菌进行鉴别;对多药耐药菌和正常阴道定植菌进行分析,探讨与产妇切口感染之间的关系,采用SPSS13.0统计软件进行处理。结果 230例待产妇经筛查,有189例为阴道正常定植菌,有41例为多药耐药菌;其中正常定植菌的产妇无一例感染,而多药耐药菌的产妇有6例感染,感染率为14.6%;检出41株多药耐药菌分别为耐β-内酰胺酶大肠埃希菌、耐甲氧西林金黄色葡萄球菌、耐甲氧西林凝固酶阴性葡萄球菌,分别占9.8%、22.0%、68.2%;剖宫产产妇感染率为9.8%,会阴侧切产妇感染率为4.9%,差异有统计学意义(P<0.05)。结论正常定植菌与产后切口感染无明显关系,多药耐药菌阴道定植与产后切口感染密切相关;并且,不同的分娩方式也与感染有一定的关系。OBJECTIVE To explore the related factors for vaginal colonization of multidrug-resistant organisms and incision infections in puerpera so as to provide guidance for clinical prevention and treatment.METHODS A total of230 puerpera who were hospitalized to give birth from Aug 2012 to Mar 2014 were recruited as the study objects,then the vaginal secretions were collected from the subjects,meanwhile,the normal bacteria and the multidrug-resistant organisms were identified by using ATB bacterial identification system,the multidrug-resistant organisms and the normal vaginal colonized bacteria were analyzed,the relationship between the vaginal colonization of multidrug-resistant organisms and the incision infections in the puerpera was observed,and the statistical analysis was performed with the use of SPSS13.0software.RESULTS Of the 230 puerpera,189were screened out as the normal vaginal colonized bacteria,and 41 were screened out as the multidrug-resistant organisms.No puerpera had infections among the puerpera colonized with normal bacteria,however,6had infections among the puerpera colonized with multidrug-resistant organisms,with the infection rate of 14.6%.Totally 41 strains of multidrug-resistant organisms were isolated,of which 9.8% wereβ-lactamase-producing Escherichia coli,22.0% were methicillin-resistant Staphylococcus aureus,and 68.2% were methicillin-resistant coagulase-negative Staphylococcus.The infection rate was 9.8%in the puerpera undergoing cesarean section,4.9%in the puerpera undergoing episiotomy,and there was significant difference（P〈0.05）.CONCLUSION The postpartum infection is not significantly correlated with the normal colonized bacteria,the vaginal colonization of the multidrug-resistant organisms is closely correlated with the postpartum infections,furthermore,the mode of delivery shows certain relationship with the infections.

关 键 词：产妇 多药耐药菌 阴道定植 切口感染 相关因素 

分 类 号：R719[医药卫生—妇产科学]