肛周脓肿术后切口感染病原菌及其危险因素  

Pathogenic bacteria of postoperative incision infections in perianal abscess and their risk factors

作　　者：王祥盛 胡冰辉 马万里 卢秀芬[1] 张晓明 李凤盛 王炳杰[1] WANG Xiang-sheng;HU Bing-hui;MA Wan-li;LU Xiu-fen;ZHANG Xiao-ming;LI Feng-sheng;WANG Bing-jie(Xingtai People's Hospital,Xingtai,Hebei 054000,China;不详)

机构地区：[1]邢台市人民医院肛肠外科,河北邢台054000 [2]邢台市人民医院整形烧伤科,河北邢台054000 [3]邢台市信都区人民医院普外科,河北邢台054000

出　　处：《中华医院感染学杂志》2024年第11期1702-1705,共4页Chinese Journal of Nosocomiology

基　　金：河北省科研基金资助项目(2021JH024021)。

摘　　要：目的探讨肛周脓肿术后切口感染病原菌及其危险因素.方法选取2020年1月-2022年12月于邢台市人民医院行肛周脓肿切开引流术患者115例,根据术后切口感染情况分为感染组和非感染组,分别为34例、81例;统计肛周脓肿患者术后切口感染的病原菌及其耐药性;分析两组临床资料,通过Logistic分析法对肛周脓肿患者术后切口感染危险因素进行归纳.结果肛周脓肿术后切口感染患者共培养分离病原菌51株,其中革兰阴性菌31株占60.78%,革兰阳性菌20株占39.22%,以大肠埃希菌、金黄色葡萄球菌和铜绿假单胞菌为主;大肠埃希菌对头孢曲松和哌拉西林耐药率较高,亚胺培南较敏感;金黄色葡萄球菌对青霉素和红霉素耐药率较高,万古霉素和替考拉宁较敏感;铜绿假单胞菌对头孢他啶和头孢曲松耐药率较高,环丙沙星较敏感;Logistic回归分析结果显示,住院时间、深部脓肿、肛周皮肤感染灶是肛周脓肿患者术后切口感染的危险因素(P<0.05).结论肛周脓肿患者术后切口感染病原菌以大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌为主;临床可根据危险因素对患者行针对性治疗和干预,以减少肛周脓肿患者术后切口感染风险.OBJECTIVE To investigate the pathogenic bacteria of postoperative incision infection in perianal abscess and their risk factors.METHODS A total of 115 patients who underwent incision and drainage for perianal abscess in Xingtai People's Hospital from Jan.2020 to Dec.2022 were selected and were divided into infected and non-infected groups according to postoperative incision infection,34 and 8l cases respectively.The pathogenic bacteria and their drug resistance of postoperative incision infection in patients with perianal abscess were analyzed.The clinical data of the two groups were analyzed and the risk factors of postoperative incision infection in patients with perianal abscess were summarized by logistic analysis.RESULTS A total of 5l strains of pathogenic bacteria were isolated from perianal abscess patients with postoperative incision infection,of which 31 strains of gram-negative bacteria accounted for 60.78%,and 20 strains of gram-positive bacteria accounted for 39.22%,mainly Escherichia coli,Staphylococcus aureus and Pseudomonas aeruginosa.Escherichia coli had higher drug resistance to ceftriaxone and piperacillin,while was more sensitive to imipenem.Staphylococcus aureus had higher resistance to penicillin and erythromycin,while was more sensitive to vancomycin and teicolanin.Pseudomonas aeruginosa had higher resistance rate to ceftazidime and ceftriaxone,while was more sensitive to ciprofloxacin.Logistic regression analysis showed that the duration of hospitalization,deep abscess and perianal skin infection were the factors affecting postoperative incision infection in perianal abscess patients(P<O.05).CONCLUSION The main pathogens of postoperative incision infection in patients with perianal abscess were Escherichia coli,Staphylococcus aureus and Pseudomonas aeruginosa.According to these risk factors,targeted treatment and intervention could be performed to reduce the risk of postoperative incision infection in patients with perianal abscess.

关 键 词：肛周脓肿 切口感染 病原菌 耐药性 危险因素 

分 类 号：R266[医药卫生—中医外科学]