剖宫产术后切口感染病原学特点及其危险因素分析  

Etiological characteristics and risk factors of incisional infections after cesarean section

作　　者：郑小玲[1] 胡莉娜[1] 孙亚青 危先江 刘玲[1] 

机构地区：[1]杭州市红十字会医院妇产科,浙江杭州310004

出　　处：《中华医院感染学杂志》2017年第21期4978-4981,共4页Chinese Journal of Nosocomiology

摘　　要：目的研究剖宫产术后切口感染病原学特点及其危险因素分析。方法选取2015年1月-2016年1月医院收治的321例产妇,收集所有患者的临床资料,分析剖宫产术后切口感染率、病原学特点及其发生的相关危险因素。结果剖宫产患者术后发生切口感染83例,感染率25.86%;83例切口感染患者血培养出病原菌98株,革兰阴性菌43株、占43.88%,革兰阳性菌50株、占51.02%,真菌5株、占5.10%;大肠埃希菌对左氧氟沙星、美罗培南、头孢哌酮/舒巴坦、头孢西丁以及诺氟沙星具有较强敏感性,而对阿莫西林、磺胺甲噁唑/甲氧芐啶具有较强耐药性;屎肠球菌及粪肠球菌对左氧氟沙星、头孢哌酮/舒巴坦、美罗培南、头孢西丁具有较强敏感性,而对阿莫西林、头孢曲松、磺胺甲噁唑/甲氧芐啶具有较强耐药性;单因素分析显示患者的年龄、术中出血量、手术时间、肥胖、妊娠伴合并症、留置尿管时间、术前导尿为影响剖宫产术后发生切口感染发生的相关因素;通过logistic分析,年龄、术中出血量、手术时间、肥胖、妊娠伴合并症、留置尿管时间、术前导尿及胎膜早破均是剖宫产术后发生切口感染的独立危险因素。结论导致剖宫产术后发生切口感染的因素很多,临床上需及时关注孕妇潜在的危险因素,及时行个体化防护,并尽量减少手术时间、控制术中出血量、严控术前导尿及留置尿管时间等,从而减少切口感染的发生。OBJECTIVE To investigate etiological characteristics and risk factors of incisional infections after cesarean section.METHODS：A total of 321 pregnant women admitted to hospital from Jan.2015 to Jan.2016 were selected.The clinical data of all patients were collected to explore the infection rate,etiological characteristics and relevant risk factors of incisional infections after cesarean section.METHODS A total of 321 pregnant women admitted to hospital from Jan.2015 to Jan.2016 were selected.The clinical data of all patients were collected to explore the infection rate,etiological characteristics and relevant risk factors of incisional infections after cesarean section.RESULTS There were 83 cases of incisional infections after cesarean section,and the infection rate was25.86%.A total of 98 strains of pathogenic bacteria were co-cultured in 83 patients with incisional infections after cesarean section,including 43 strains of gram-negative bacteria,accounting for 43.88%,50 strains of gram-positive bacteria,accounting for 51.82%,and 5 strains of fungi,accounting for 5.10%.Escherichia coli was highly sensitive to levofloxacin,meropenem,cephaloside and sulbactam,cefoxitin and norfloxacin,and highly resistant to amoxicillin,sulfamethoxazole/trimethoprim.Enterococcus faeciumand Enterococcus faecalis had strong sensitivity to levofloxacin,cephaloside and sulbactam,meropenem and cefoxitin,and had strong resistance to amoxicillin,ceftriaxone,sulfamethoxazole/trimethoprim.Univariate analysis showed that age,intraoperative blood loss,operation time,obesity,pregnancy with complications,indwelling catheter time and preoperative catheterization were risk factors for the occurrence of incision infections after cesarean section.Logistic analysis showed that,age,intraoperative blood loss,operation time,obesity,pregnancy with complications,indwelling catheter time,preoperative catheterization and premature rupture of membranes were independent risk factors for incision infections after cesarean section.CONCLUSIONThere are many fa

关 键 词：剖宫产术 切口感染 病原学特点 危险因素 

分 类 号：R619.3[医药卫生—外科学]