肾盂及输尿管取石术患者术后切口感染病原菌分布与耐药性及预后分析  

Distribution,drug resistance and prognosis analysis of pathogenic bacteria of postoperative incision infections in patients with renal pelvis and ureter lithotomy

作　　者：郭姝馨[1] 苏晓萍[1] 张燕美[1] 施美珍 蔡翠珊 

机构地区：[1]福建医科大学附属第二医院泌尿外科,福建泉州362000

出　　处：《中华医院感染学杂志》2017年第23期5377-5379,5383,共4页Chinese Journal of Nosocomiology

基　　金：福建省自然科学基金资助项目(2012J01372)

摘　　要：目的调查分析121例肾盂及输尿管取石术患者术后切口感染的病原菌分布及多种耐药菌耐药性情况,以期为预防感染的发生及感染的后期治疗提供帮助。方法回顾性分析2013年7月-2015年7月医院收治的肾盂及输尿管取石术患者489例,对其中121例术后切口感染患者进行调查分析,取其标本做细菌培养和药敏试验,分析术后感染多种耐药菌分布及其耐药性情况。结果 489例肾盂及输尿管取石术患者中121例发生术后切口感染,感染率为24.74%;传统开放性切开术后切口感染率最高,感染率为40.32%;121例送检标本分离出病原菌128株,以革兰阴性菌为主,共94株占73.44%;128株病原菌中多药耐药菌72株,占56.25%;大肠埃希菌对亚胺培南和磺胺甲噁唑/甲氧苄啶耐药率较低,克雷伯杆菌对亚胺培南和左氧氟沙星耐药率较低。结论为减少肾盂及输尿管取石术后切口感染率,需积极采取有效的措施,根据药敏实验结果,合理选择抗菌药物,有效控制感染。OBJECTIVE To investigate the distribution of pathogenic bacteria and drug resistance of 121 cases of postoperative incision infections in patients with renal pelvis and ureter lithotomy,so as to provide help for the prevention and treatment of infections.METHODS A total of of 489 cases of patients with renal pelvis and ureter lithotomy from Jul.2013 to Jul.2015 in our hospital were retrospectively analyzed,121 cases of postoperative incision infections were investigated and analyzed,and the specimens were used for bacterial culture and drug sensitivity test,in order to analyze the distribution and drug resistance of multiple drug resistant strains.RESULTS Among 489 cases of patients with renal pelvis and ureter lithotomy,121 cases had postoperative incision infections,and the infection rate was 24.74%.The postoperative incision infection rate of traditional open incision was the highest,and the infection rate was 40.32%.Totally 128 strains of pathogens were isolated from 121 cases of specimens,which were mainly 94 strains of gram-negative bacteria,accounting for 73.44%.Among 128 strains of isolated pathogens,72 strains were multidrug-resistant bacteria,accounting for 56.25%.Escherichia coli had low resistant rate to imipenem and cotrimoxazole/trimethoprim,Klebsiella pneumoniae had low resistant rate to imipenem and levofloxacin.CONCLUSIONIn order to reduce the incision infection rate after renal pelvis and ureter lithotomy,we should take effective measures,and select antibiotics rationally according to the results of drug sensitivity test,so as to control infection effectively.

关 键 词：肾盂及输尿管取石术 切口感染 病原菌 多药耐药菌 耐药性 

分 类 号：R619.3[医药卫生—外科学]