胆石症术后腹腔感染的病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens causing postoperative abdominal infection in patients with cholelithiasis

作　　者：张清军[1] 陈芸[1] 徐强 刘柯 孙建 ZHANG Qing-jun;CHEN Yun;XU Qiang;LIU Ke;SUN Jian(Zibo Central Hospital Zibo,Shandong 255000,China)

机构地区：[1]淄博市中心医院肝胆外科

出　　处：《中华医院感染学杂志》2019年第22期3448-3452,共5页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(ZR2015HM031)

摘　　要：目的分析胆石症术后腹腔感染的病原菌分布及耐药性,为抗感染治疗工作提供客观依据。方法选取2014年8月-2018年8月淄博市中心医院收治的1468例胆石症患者作为研究对象,对其术后腹腔感染情况及病原菌分布、耐药性进行回顾性分析。结果有142例患者术后发生腹腔感染,感染率为9.67%。共检出127株病原菌,其中,革兰阴性菌79株占62.2%,革兰阳性菌44株占34.65%,真菌4株占3.15%。革兰阴性菌对阿米卡星、头孢哌酮/舒巴坦等的耐药率较低,对红霉素、庆大霉素等的耐药率较高。革兰阳性菌对青霉素G、氨苄西林等的耐药率较高。检出14株产超广谱β-内酰胺酶大肠埃希菌、5株耐甲氧西林金黄色葡萄球菌。结论胆石症患者术后腹腔感染的病原菌以革兰阴性肠杆菌和革兰阳性肠球菌为主,这些病原菌对于多种常用抗菌药物具有较高的耐药率,多药耐药菌株的检出率较高,临床医生应根据药敏试验结果制订合理的抗感染治疗方案,以确保治疗效果、减少耐药现象。OBJECTIVE To explore the distribution and drug resistance of pathogens causing postoperative abdominal infection in patients with cholelithiasis so as to provide objective basis for treatment of infection.METHODS A total of 1468 patients with cholelithiasis who were treated Zibo Central Hospital from Aug 2014 to Aug 2018 were recruited as the study objects.The incidence of postoperative abdominal infection,distribution and drug resistance of pathogens were retrospectively analyzed.RESULTS Totally 142 patients had postoperative abdominal infection,with the infection rate 9.67%.A total of 127 strains of pathogens were isolated,79(62.2%)of which were gram-negative bacteria,44(34.65%)were gram-positive bacteria,and 4(3.15%)were fungi.The drug resistance rates of the gram-negative bacteria to amikacin and cefoperazone-sulbactam were low,while the drug resistance rates to erythromycin and gentamicin were high.The drug resistance rates of the gram-positive bacteria to penicillin G and ampicillin were high.Totally 14 strains of extended spectrumβ-lactamase-producing Escherichia coli and 5 strains of methicillin-resistant Staphylococcus aureus were isolated.CONCLUSION The gram-negative Enterobacter and gram-positive Enterococcus are dominant among the pathogens isolated from the cholelithiasis patients with postoperative abdominal infection and are highly resistant to multiple commonly used antibiotics,the isolation rate of multidrug-resistant strains is high.It is necessary for clinicians to formulate the anti-infection programs based on the result of drug susceptibility testing so as to ensure the therapeutic effect and reduce the drug resistance rate.

关 键 词：胆石症 术后腹腔感染 病原菌分布 耐药性分析 

分 类 号：R44[医药卫生—诊断学]