淮安市某院泌尿外科患者切口感染病原菌特征及因素分析  

Pathogenic bacteria and factors analysis of incision infection in urological patients at a hospital in Huai'an

作　　者：顾婷婷 张梦婷 徐沭 王海梅[1] 杨熙文 高欢 GU Tingting;ZHANG Mengting;XU Shu;WANG Haimei;YANG Xiwen;GAO Huan(Urology Department of Huai'an Second People's Hospital,Huai'an,Jiangsu 223001,China)

机构地区：[1]淮安市第二人民医院泌尿外科,江苏淮安223001

出　　处：《医学动物防制》2024年第6期575-579,共5页Journal of Medical Pest Control

基　　金：江苏省重点研发计划专项资金项目(BE2018645)。

摘　　要：目的调查分析2018—2021年淮安市某医院泌尿外科手术患者切口感染的病原菌分布情况、耐药性及危险因素。方法选取2018年1月—2021年12月淮安市某医院收治的300例泌尿外科手术患者作为研究对象,根据术后切口感染情况将其分为感染组和未感染组。采用描述性分析法描述泌尿外科手术患者的病原菌分布情况以及耐药性。对比感染组、未感染组患者的临床因素差异,泌尿外科手术患者发生病原菌感染占比采用描述性分析,计量资料用独立样本t检验,计数资料以例数和占比n(%)表示,用χ^(2)检验。多因素logistic分析术后病原菌感染的影响因素。结果泌尿外科手术患者术后的切口感染率为24.00%,感染组患者72例,未感染组患者228例,72例标本检出病原菌100株,革兰阴性菌占72.00%。多重耐药菌44株,大肠埃希菌(Escherichia coli,E.coli)、肺炎克雷伯菌(Klebsiella pneumoniae,KPN)、铜绿假单胞菌(Pseudomonas aeruginosa,PAE)多重耐药率分别为45.45%、29.55%和25.00%。E.coli、KPN对哌拉西林的耐药率均为100.00%,E.coli对庆大霉素的耐药率为100.00%,KPN对头孢他啶的耐药率为100.00%,PAE对庆大霉素、头孢他啶的耐药率均为18.18%,E.coli、KPN、PAE对亚胺培南均无耐药性。感染组患者年龄≥60岁、BMI≥24kg/m^(2)、糖尿病、Ⅲ类切口、手术时间≥120min、住院时间≥10d、术后留置导尿管时间≥3d、休克的比例均明显升高,差异有统计学意义(χ^(2)=51.398、46.026、5.210、48.566、34.223、29.728、28.374、7.103,P<0.05),以上各项因素均是泌尿外科手术患者术后发生切口感染的独立危险因素(χ^(2)=3.143、5.011、3.011、2.209、4.159、8.244、5.344、4.785,P<0.05)。结论泌尿外科手术患者术后切口易感染,革兰阴性菌是其主要病原菌并且E.coli、KPN、PAE具有多重耐药性,年龄、BMI、糖尿病、手术与住院指标等均是影响切口感染的因素,可作为后续的研究新Objective To investigate and analyze the distribution of pathogenic bacteria,drug resistance and risk factors of incision infection in patients undergoing urological surgery at a hospital in Huai'an from 2018 to 2021.Methods Three hundred urological surgery patients admitted to a hospital in Huai'an from January 2018 to December 2021 were selected as the study objects.The patients were categorized into infected and uninfected groups based on postoperative incision infection.Descriptive analysis was employed to depict pathogen distribution and drug resistance in patients undergoing urological surgery.Differences in clinical factors were compared between patients in the infected and uninfected groups.Descriptive analysis was used for the proportion of pathogenic bacteria infection in urological surgery patients,independent sample t test was used for measurement data,and the count data was expressed by the number of cases and the proportion n(%),andχ^(2)test was used.The influencing factors of postoperative pathogenic bacterial infection were analyzed by multivariate logistic analysis.Results The postoperative incision infection rate in urological surgery patients was 24.00%,with 72 patients in infected group and 228 patients in uninfected group.A total of 100 strains of pathogenic bacteria were detected in 72 samples,with Gram-negative bacteria accounted for 72.00%.The 44 strains of multidrug-resistant bacteria included Escherichia coli(E.coli),Klebsiella pneumoniae(KPN),Pseudomonas aeruginosa(PAE),with multiple drug resistance rates of 45.45%,29.55%and 25.00%,respectively.The resistance rate of E.coli and KPN to piperacillin was all 100.00%,the resistance rate of E.coli to gentamicin was 100.00%,the resistance rate of KPN to ceftazidime was 100.00%,and the resistance rate of PAE to gentamicin and ceftazidime was all 18.18%.E.coli,KPN and PAE were not resistant to imipenem.In the infection group,the proportions of patients with age≥60 years,BMI≥24kg/m^(2),diabetes mellitus,type Ⅲ incision,operation time≥12

关 键 词：泌尿外科 切口感染 危险因素 病原菌分布 耐药性 革兰阴性菌 

分 类 号：R619.3[医药卫生—外科学]