妇科恶性肿瘤术后感染病原菌分布及耐药性分析  

Analysis of the distribution and drug resistance of pathogenic bacteria after surgery for gynecological malignancies

作　　者：陈丽妹[1] 吴志辉[2] 陈岩松[1] 辛娜[1] 霍然 陈燕[1] Chen Li-mei;Wu Zhi-hui;Chen Yan-song;Xin Na;Huo Ran;Chen Yan(Fujian Cancer Hospital and Fujian Medical University Cancer Hospital,Fuzhou 350014;Fujian Provincial Maternity and Children’s Hospital,affiliated hospital of Fujian Medical University,Fuzhou 350001)

机构地区：[1]福建省肿瘤医院,福建医科大学附属肿瘤医院,福州350014 [2]福建省妇幼保健院,福建医科大学附属医院,福州350001

出　　处：《中国抗生素杂志》2021年第12期1152-1156,共5页Chinese Journal of Antibiotics

摘　　要：目的分析我院妇科恶性肿瘤术后感染病原菌分布及耐药情况,探讨妇科恶性肿瘤患者围手术期预防用药及术后抗感染药物的选择,为合理使用抗菌药物提供理论依据。方法回顾性分析2016—2020年妇科恶性肿瘤患者术后感染情况,病原菌采用K-B纸片扩散法结合VITEKⅡ仪器法进行鉴定及药敏试验。按2020年美国临床实验室标准化委员会(CLSI)标准判断结果,采用WHONET5.6进行统计。结果妇科恶性肿瘤术后感染率为11.33%,以泌尿系统感染为主,大肠埃希菌检出率占居首位,其次是粪肠球菌、肺炎克雷伯菌,前3位构成比合计达86.16%。大肠埃希菌、肺炎克雷伯菌对头孢唑林、头孢呋辛等耐药率>50%。粪肠球菌对四环素、红霉素耐药率>50%,对高浓度庆大霉素、环丙沙星等耐药率>30%。耐甲氧西林金黄色葡萄球菌(MRSA)为28.57%。结论本院妇科恶性肿瘤患者术后感染以泌尿系统感染为主,病原菌种类繁多、耐药现象严重。妇科恶性肿瘤手术在围手术期预防用药及术后抗感染治疗时,应考虑多种微生物感染的特性及其耐药情况。Objective To analyze the distribution of infectious pathogens and drug resistance of gynecological malignant tumors in our hospital,explore the perioperative preventive medication and postoperative antibacterial drugs for patients with gynecological malignant tumors,and provide a theoretical basis for the rational use of antibacterial drugs.Methods A retrospective analysis of the postoperative infections of patients with gynecological malignancies from 2016 to 2020 was conducted.The pathogenic bacteria were identified by the antimicrobial susceptibility test using the K-B disc diffusion method combined with the VITEK II instrument method.The results were evaluated according to the 2020 Clinical Laboratory Standardization Committee(CLSI)standards.Results The postoperative infection rate of gynecological malignant tumors was 11.33%.Urinary system infection was the main cause.The detection rate of Escherichia coli took the first place,followed by Enterococcus faecalis and Klebsiella pneumoniae.The top three pathogenic bacteria combined were up to 86.16%.The resistance rate of Escherichia coli and Klebsiella pneumoniae to cefazolin and cefuroxime was higher than 50%.The resistance rates of Enterococcus faecalis to tetracycline and erythromycin were higher than 50%,and the resistance rates to high concentrations of gentamicin and ciprofloxacin were more than 30%.Methicillin-resistant Staphylococcus aureus(MRSA)was 28.57%.Conclusion Postoperative infections of patients with gynecological malignancies in our hospital are mainly urinary system infections.There are many types of pathogenic bacteria and serious drug resistance.In the perioperative preventive medication and postoperative anti-infection treatment of gynecological malignant tumor surgery,the characteristics of multiple microbial infections and their drug resistance should be considered.

关 键 词：妇科恶性肿瘤 术后感染 病原菌分布 耐药性 

分 类 号：R978.1[医药卫生—药品]