腹部外科术后患者腹腔感染的病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens in patients with intra-abdominal infections after surgery

作　　者：王宇[1] 赵英[1] 张峰[1] 吕谦[1] 郑永绵[1] 王智[1] 张玉华[1] 史宪杰[2] 

机构地区：[1]鞍山市中心医院普外一科,辽宁鞍山114001 [2]解放军总医院肝胆外科,北京100853

出　　处：《中华医院感染学杂志》2016年第15期3464-3466,共3页Chinese Journal of Nosocomiology

基　　金：全军医学科学技术研究"十二五"计划基金资助项目(CWS11J096)

摘　　要：目的探讨普外科腹腔术后感染的病原菌分布及其耐药性,以指导临床合理应用抗菌药物治疗。方法收集医院2012年5月-2015年5月142例术后合并腹腔感染患者的临床资料,分析感染病原菌分布特点及其耐药性,数据采用SPSS 17.0软件进行统计分析。结果 142例术后腹腔感染患者,共分离出204株病原菌,以革兰阴性菌为主,共121株占59.3%;鲍氏不动杆菌对亚胺培南的耐药率高达46.2%,对氨曲南几乎完全耐药;经治疗后,最终125例治愈出院,救治成功率达88.0%。结论腹部外科患者术后腹腔感染病原菌中革兰阴性菌所占比例高于革兰阳性菌,且多药耐药比例较高;随着病原菌分布及耐药性的变化,根据其药敏试验结果指导临床用药,是有效治疗腹腔感染的重要手段。OBJECTIVE To investigate the distribution and drug resistance of pathogens in patients with intra-abdominal infections after surgery in the department of general surgery,so as to guide the clinical rational use of antibiotics.METHODS A total of 142 patients with intra-abdominal infections after surgery from May 2012 to May2015in our hospital were retrospectively collected,and the distribution and drug resistance of pathogens were analyzed.The data were analyzed by SPSS 17.0.RESULTS A total of 204 strains of pathogens were isolated in 142 patients with intra-abdominal infections after surgery,and mainly was gram-negative bacteria,accounting for 121strains（59.3%）.The drug resistance rate of Acinetobacter baumanii to imipenem was 46.2% and almost completely resistant to aztreonam.Totally 125 patients were cured after s series of treatment,with the cure rate of88.0%.CONCLUSIONThe proportion of gram-negative bacteria was higher than that of gram-positive bacteria in patients who suffer from abdominal infection after surgery,and they all had a higher proportion of multiple drug resistance.Accompany the changing of pathogens＇ distribution and drug resistance,it is an important method to treat the infection according to the results of drug sensitive test.

关 键 词：腹腔感染 病原菌 耐药性 治疗 

分 类 号：R181.32[医药卫生—流行病学]