中老年腹部手术切口感染的病原菌分布及耐药性分析  

Analysis of pathogen distribution and drug resistance of abdominal incision infection in middle-aged and elderly patients

作　　者：杨小兰[1] 胡增军[2] 马淑霞 曾永杰 YANG Xiao-lan;HU Zeng-jun;MA Shu-xia;ZENG Yong-jie(Clinical Laboratory,the First People's Hospital of Baiyin,Baiyin,Gansu 730900,China;不详)

机构地区：[1]白银市第一人民医院检验科,甘肃白银730900 [2]甘肃省中医院白银分院科教科,甘肃白银730900

出　　处：《中国卫生检验杂志》2021年第4期434-437,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨中老年腹部手术切口感染患者的病原菌分布及其耐药情况,为临床合理有效选用抗菌药物提供依据。方法收集2014年1月-2019年6月本院外科收治的2 750例中老年腹部手术患者临床资料,统计感染情况及其分泌物细菌培养鉴定结果,分析病原菌分布及耐药情况。结果 2 750例患者出现腹部感染232例,感染发生率8.36%;232例腹部切口感染者切口分泌物分离出病原菌291株,其中革兰阴性菌占比58.76%,革兰阳性菌占比34.02%,真菌占比7.22%;主要革兰阴性菌对头孢唑啉、哌拉西林、头孢噻肟、头孢曲松耐药率为30%~100%;主要革兰阳性菌对克林霉素、复方新诺明、红霉素、青霉素、氨苄西林耐药率为30%~100%。结论中老年腹部手术切口感染多以革兰阴性菌、革兰阳性菌为主。对已发生感染的患者,应合理规范使用感染菌敏感的药物,防止感染的扩散与发展。Objective To investigate the distribution of pathogenic bacteria and drug resistance in middle-aged and elderly patients with abdominal incision infection,so as to provide basis for the rational and effective selection of antibiotics.Methods Clinical data of 2750 middle-aged and elderly patients receiving abdominal surgery in our hospital from January 2014 to June 2019 was collected,the infection status and bacterial culture identification results of secretions were counted,and the distribution and drug resistance of pathogens were analyzed.Results There were 232 cases of abdominal infection in 2750 patients and the infection rate was 8.36%.291 strains of pathogenic bacteria were isolated from the secretions of 232 patients with abdominal incisional infection,among which 58.76%were gram-negative bacteria,34.02%were gram-positive bacteria and 7.22%were fungi.The resistance rate of main gram-negative bacteria to cefazoline,piperacillin,cefotaxime and ceftriaxone was within 30%-100%.Likewise,the resistance rate of main gram-positive bacteria to clindamycin,cotrimoxazole,erythromycin,penicillin and ampicillin was within 30%-100%.Conclusion The infection of abdominal incision in middle-aged and elderly patients is mainly caused by gram-negative bacteria and gram-positive bacteria.In order to prevent the spread and development of infection,it is necessary to use infection-sensitive drugs in a rational and standardized manner for the infected patients.

关 键 词：腹部切口 老年 感染 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]