剖宫产术后切口感染的病原学、危险因素和耐药性分析  

Analysis of etiology,risk factors and drug resistance of incision infection after cesarean section

作　　者：李欣 焦艳[1] 王蒙 Li Xin;Jiao Yan;Wang meng(Xuzhou Central Hospital,Xuzhou 221000,China)

机构地区：[1]江苏省徐州市中心医院,徐州221000

出　　处：《广西医科大学学报》2018年第9期1253-1255,共3页Journal of Guangxi Medical University

摘　　要：目的:探讨剖宫产后切口感染病原菌的病原学、耐药性以及危险因素,以指导临床用药。方法:回顾性分析2015年1月至2017年1月江苏省徐州市中心医院收治的剖宫产956例患者的临床资料,统计切口感染发生率,分析比较不同年龄、体重指数、羊水污染程度、孕期并发症、瘢痕子宫、阴道检查次数、手术时间及出血量产妇的切口感染发生率,对其行单因素分析以及多因素Logistic回归分析。对患者切口处的分泌物进行细菌培养,并进行细菌耐药性实验。结果:Logistic回归分析结果表明,体重指数、孕期并发症、阴道检查次数以及出血量是术后切口感染的独立危险因素(均P<0.05)。术后切口感染的病原菌中金黄色葡萄球菌和凝固酶阴性葡萄球菌是耐药菌的优势菌株,但对万古霉素敏感。结论:减少术中出血量、增强产妇体质、减少术后并发症以及减少阴道检查次数是降低术后感染的重要手段,致病菌对常用的抗菌药物耐药性较强,临床上应合理运用抗菌药物。Objective： To investigate the etiology,drug resistance and risk factors of incision infection after cesarean section,in order to reduce the infection rate and guide the clinical application.Methods： The clinical data form 956 cesarean section patients in our hospital from January 2015 to January 2017 were retrospectively analyzed.The incidence of incision infection among different age,different body mass index,amniotic fluid pollution degree,complications of pregnancy,scar uterine,vaginal examination times,operation time and bleeding volume were compared.The risk factors of incision infection were analyzed by multivariate logistic regression analysis.The secretions of the incision were isolated and identified by bacterial culture.Then the drug resistance test was carried out by the paper diffusion method.Results： Logistic regression analysis showed that the body mass index,complications of pregnancy,vaginal examination times,and blood-loss volume were risk factors for postoperative wound infection （ P 〈0.05）. Staphylococcus aureus and coagulase-negative Staphylococci in the wound infection pathogens are the dominant strains of resistant bacteria,but sensitive to vancomycin.Conclusion： It is an important means to reduce the postoperative infection by reducing the amount of intraoperative blood loss,strengthening maternal constitution,reducing postoperative complications and the number of guided examinations.The pathogens are highly resistant to commonly used antimicrobial agents,and the antibacterial agents should be used reasonably in clinic.

关 键 词：剖宫产术后切口感染 病原学 危险因素 耐药性 

分 类 号：R719.8[医药卫生—妇产科学]