胃癌并发糖尿病老年患者术后感染的病原菌分布及耐药性分析  

Pathogenic bacteria distribution and drug resistance of postoperative infection in elderly patients with gastric cancer complicated with diabetes mellitus

作　　者：黄国飞[1] 李俊[1] 贺俊文[1] 杨勇[1] 张小为[1] 安亮[1] HUANG Guofei;LI Jun;HE Junwen;YANG Yong;ZHANG Xiaowei;AN Liang(Department of Gastrointestinal Vascular Surgery,Deyang People′s Hospital, Deyang,Sichuan 618000,China)

机构地区：[1]德阳市人民医院胃肠血管外科,四川德阳618000

出　　处：《国际检验医学杂志》2018年第8期922-924,928,共4页International Journal of Laboratory Medicine

基　　金：四川省卫计委科研项目(130416)

摘　　要：目的探讨胃癌合并糖尿病老年患者术后感染的病原菌分布及耐药性。方法选取该院2010年3月至2017年3月期间收治的胃癌合并糖尿病老年患者367例。采集患者标本分离培养细菌,革兰阳性菌药敏试验采用GN201法,革兰阴性菌药敏试验采用GP法,以纸片扩散法进行药敏试验。结果胃癌合并糖尿病老年患者术后感染患者68例,分离培养病原菌79株。革兰阴性菌中,主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌。革兰阳性菌中,主要为金黄色葡萄球菌、表皮葡萄球菌。主要革兰阴性菌中,大肠埃希菌对头孢他啶和左氧氟沙星耐药率较高,分别为93.33%和80.00%;肺炎克雷伯菌对头孢哌酮和环丙沙星耐药率较高,分别为76.92%和69.23%;铜绿假单胞菌对左氧氟沙星耐药率较高,为80.00%。主要革兰阳性菌中,金黄色葡萄球菌对青霉素和红霉素耐药率较高,分别为91.67%和83.33%;表皮葡萄球菌对青霉素和红霉素耐药率较高,分别为100.00%和77.78%。结论胃癌合并糖尿病老年患者术后感染的病原菌分布以革兰阴性菌为主,主要病原菌中大肠埃希菌对头孢他啶和左氧氟沙星耐药率较高,肺炎克雷伯菌对头孢哌酮和环丙沙星耐药率较高,绿假单胞菌对左氧氟沙星耐药率较高,临床上应根据药敏试验合理应用抗菌药物。Objective To investigate the distribution and drug resistance of pathogens in elderly patients with gastric cancer complicated with diabetes mellitus.Methods 367 elderly patients with gastric cancer and diabetes mellitus were selected from the hospital from March 2010 to March 2017.The samples were isolated and cultured.The Gram positive bacteria were tested by GN201,the Gram negative bacteria susceptibility test was carried out by GP,and the drug susceptibility test was carried out by disk diffusion method.Results There were 68 cases of postoperative infection in gastric cancer patients with diabetes mellitus,and 79 strains were isolated and cultured.Among the gram negative bacteria,Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa were the main pathogens.Among the Gram positive bacteria,Staphylococcus aureus and Staphylococcus epidermidis were the main pathogens.The main Gram negative bacteria,Escherichia coli to ceftazidime with levofloxacin resistance rates were 93.33%and 80.00%;Klebsiella pneumoniae had a higher drug resistance rate for cefoperazone and ciprofloxacin,76.92%and 69.23%respectively;a relatively high rate of Pseudomonas aeruginosa resistant to levofloxacin was 80.00%.Among the gram positive bacteria,the resistance rates of Staphylococcus aureus to penicillin and erythromycin were relatively high,respectively 91.67%and 83.33%.Staphylococcus epidermidis had relatively high resistance rates to penicillin and erythromycin,100.00%and 77.78%respectively.Conclusion Gastric cancer complicated by diabetes mellitus elderly patients with postoperative infection of pathogenic bacteria distribution is given priority to with Gram-negative bacteria was the most common in,Pseudomonas aeruginosa,the main pathogenic bacteria of Escherichia coli to ceftazidime with levofloxacin resistant rate of Klebsiella pneumoniae was higher on cefoperazone and ciprofloxacin resistant Pseudomonas aeruginosa,the resistance rate of Pseudomonas aeruginosa to levofloxacin is high,and it is important to apply antibio

关 键 词：胃癌 糖尿病 术后感染 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]