卵巢癌患者术后切口感染的危险因素与病原学分析  

Risk factors and etiological characteristics of postoperative incision infections in patients with ovarian cancer

作　　者：陈仲波[1] 余红萍[2] 朱笕青[1] 周建松[1] 郑智国[3] 

机构地区：[1]浙江省肿瘤医院妇瘤科,浙江杭州310022 [2]浙江医院特检科,浙江杭州310013 [3]浙江省肿瘤研究所,浙江杭州310022

出　　处：《中华医院感染学杂志》2017年第10期2314-2316,2324,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科研基金资助项目(2017KY248);浙江省中医药科学研究基金资助项目(2017ZA035)

摘　　要：目的探讨卵巢癌患者术后切口感染的危险因素、病原学特征及其耐药性,为临床防治卵巢癌患者术后切口感染提供依据。方法收集浙江省肿瘤医院2012年1月-2015年12月收治的卵巢癌患者473例,所有患者均行卵巢癌肿瘤细胞减灭术,分析术后切口感染率及危险因素,并检测病原菌及其耐药性。结果 473例行卵巢癌手术患者中,25例患者术后发生切口感染,感染率为5.29%;多因素logistic回归分析显示,FIGO分期为Ⅲ或Ⅳ期、糖尿病和异体输血是卵巢癌患者术后切口感染的危险因素(P<0.05);共分离出病原菌32株,其中革兰阳性菌14株占43.75%,革兰阴性菌18株占56.25%,最常见的病原菌为金黄色葡萄球菌(25.00%)和大肠埃希菌(28.13%);金黄色葡萄球菌对青霉素G、环丙沙星和呋喃妥因耐药率较高,大肠埃希菌对头孢替坦、磺胺甲噁唑/甲氧苄啶和氨苄西林耐药率较高。结论 FIGO分期为Ⅲ或Ⅳ期、糖尿病和异体输血是卵巢癌患者术后切口感染的危险因素,感染病原菌以革兰阴性菌为主,耐药率较高。OBJECTIVE To explore the risk factors and etiological characteristics of postoperative incision infections in patients with ovarian cancer and analyze the drug resistance so as to provide guidance for clinical prevention and treatment of the ovarian cancer patients with postoperative incision infections.METHODS A total of 473 patients with ovarian cancer who were treated in Zhejiang Cancer Hospital from Jan 2012 to Dec 2015 were enrolled in the study,all of the patients received ovarian cancer cytoreductive surgery,the incidence of postoperative incision infections and risk factors were analyzed,and the distribution and drug resistance of pathogens were observed.RESULTS Of the 473 ovarian cancer patients,25 had the postoperative incision infections,with the infection rate 5.29%.Multivariate logistic regression analysis indicated that the stage Ⅲ or Ⅳ of FIGO,diabetic mellitus,and allogeneic blood transfusion were the risk factors for the postoperative incision infections in the ovarian cancer patients （P〈0.05）.A total of 32 strains of pathogens were isolated,including 14 （43.75%） strains of gram-positive bacteria and 18 （56.25%） strains of gram-negative bacteria.Staphylococcus aureus and Escherichia coli were the most common species of pathogens,accounting for 25.00% and 28.13 %,respectively.The S.aureus strains were highly resistant to penicillin G,ciprofloxacin,and nitrofurantoin;the E.coli strains were highly resistant to cefotetan,sulfamethoxazole-trimethoprim,and ampicillin.CONCLUSION The stage Ⅲ or Ⅳ of FIGO,diabetic mellitus,and allogeneic blood transfusion are the risk factors for the postoperative incision infection in the patients with ovarian cancer.The gram-negative bacteria are dominant among the pathogens causing the infections and are highly resistant to antibiotics.

关 键 词：卵巢癌 切口感染 危险因素 耐药性 病原学 

分 类 号：R711.75[医药卫生—妇产科学]