结直肠癌患者术后切口感染病原菌分布、药敏性特征及多重耐药菌感染的影响因素分析  

Analysis of pathogen distribution,drug sensitivity characteristics and influencing factors of multi-drug resistant infection in patients with colorectal cancer

作　　者：王玲琴[1] 陈晶晶[2] 黄崇杰[1] 王兆洪[3] 陈爱华[1] WANG Ling-qin;CHEN Jing-jing;HUANG Chong-jie;WANG Zhao-hong;CHEN Ai-hua(Department of Anorectal Surgery,Second Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325027,China;不详)

机构地区：[1]温州医科大学附属第二医院肛肠外科,浙江温州325027 [2]温州医科大学附属第二医院乳腺外科,浙江温州325027 [3]温州医科大学附属第二医院肝脾外科,浙江温州325027

出　　处：《中国卫生检验杂志》2020年第17期2154-2157,共4页Chinese Journal of Health Laboratory Technology

基　　金：浙江省自然科学基金(LQ18H290003)。

摘　　要：目的探讨结直肠癌患者术后切口感染病原菌分布、药敏性特征及多重耐药菌感染的影响因素。方法选择2016年10月-2019年3月本院374例结直肠癌患者,统计术后切口感染病原菌、药敏性及影响因素。结果革兰阳性菌大肠埃希菌、铜绿假单胞菌对氨苄西林的耐药性最强;金黄色葡萄球菌对阿莫西林存在强耐药性;结直肠癌术后切口感染多重耐药菌感染与年龄、BMI、手术类型、TNM分期、手术时间、腹部手术既往史、糖尿病、术后造瘘存在相关性(P<0.05);Logistic回归分析显示,患者年龄≥60岁、BMI>24 kg/m^2、开腹手术、临床TNM分期、手术时间≥1.5 h、腹部手术既往史、糖尿病、术后造瘘为结直肠癌术后切口感染多重耐药菌感染的独立影响因素(P<0.05)。结论结直肠癌患者术后切口感染风险较高,病原菌常见为革兰阴性菌,对多种抗菌药物存在较强耐药性。Objective To investigate the distribution of pathogenic bacteria,drug sensitivity and the influencing factors of multi-drug resistant infection in patients with colorectal cancer.Methods A total of 374 patients with colorectal cancer who were admitted to our hospital from October 2016 to March 2019 were selected as the subjects.The pathogens,drug sensitivity and influencing factors of postoperative incision infection were counted.Results Gram-positive bacteria Escherichia coli and Pseudomonas aeruginosa were the most resistant to ampicillin,and Staphylococcus aureus was highly resistant to amoxicillin.Univariate analysis showed that multi-drug resistant infection of colorectal cancer after incision infection was associated with age,BMI,type of surgery,clinical TNM staging,operative time,past history of abdominal surgery,diabetes,postoperative sputum(P<0.05);Logistic regression analysis showed that patients aged≥60 years,BMI>24 kg/m^2,open surgery,clinical TNM staging,operative time≥1.5 h,previous history of abdominal surgery,diabetes,postoperative ostomy for multi-drug resistance of colorectal cancer after incision infection were independent factors affecting bacterial infection(P<0.05).Conclusion Patients with colorectal cancer have a higher risk of postoperative incision infection.The pathogens are often Gram-negative bacteria,and they are highly resistant to various antibiotics.

关 键 词：结直肠癌 术后切口感染 病原菌 药敏性特征 影响因素 

分 类 号：R446.5[医药卫生—诊断学]