某三甲医院外科手术患者切口感染病原菌分布及耐药性分析  

Analysis of the distribution and drug resistance of pathogenic bacteria in surgical incision infection patients in a third-grade class-A hospital

作　　者：杨艳[1] 杨阳 邵丰 张强 徐薇 鲍秦琴 任淑娴 YANG Yan;YANG Yang;SHAO Feng;ZHANG Qiang;XU Wei;BAO Qinqin;REN Shuxian(Department of Thoracic Surgery,Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院(胸科院区)胸外科,江苏南京210029

出　　处：《中国病原生物学杂志》2025年第3期370-372,377,共4页Journal of Pathogen Biology

摘　　要：目的探究南京医科大学附属脑科医院外科手术患者切口感染病原菌分布及耐药性。方法选择2021年6月-2022年11月南京医科大学附属脑科医院医院3867例外科手术患者为研究对象,分析患者切口感染病原菌分布及耐药性情况。结果3867例外科手术患者出现切口感染310例(8.02%),其中骨科感染较多,有103例(33.23%);感染部位中表浅切口感染有181例(58.39%),深部感染129例(41.61%);共分离出492株病原菌,其中革兰阴性菌273株(55.49%)、革兰阳性菌201株(40.85%)、真菌18株(3.66%);革兰阴性菌中的肺炎克雷伯菌对氨苄西林、环丙沙星的耐药性较强,铜绿假单胞菌对氨苄西林、头孢吡肟的耐药性较强,大肠埃希菌对氨苄西林、环丙沙星的耐药性较强;革兰阳性菌中表皮葡萄球菌对红霉素、庆大霉素的耐药性较强,粪肠球菌对万古霉素的耐药性较强,金黄色葡萄球菌对青霉素、四环素、红霉素的耐药性较强;白假丝酵母菌对两性酶素B的耐药性较强;热带假丝酵母菌对氟康唑的耐药性较强。结论及时准确地鉴定病原菌的分布与种类,并根据病原菌耐药性合理选用抗菌药物可有效预防和控制外科手术患者切口感染。Objective To investigate the distribution and drug resistance of pathogenic bacteria in surgical patients with incision infection in Brain Hospital Affiliated to Nanjing Medical University.MethodsA total of 3867 surgical patients from Brain Hospital Affiliated to Nanjing Medical University from June 2021 to November 2022 were collected as the study subjects,and the distribution and drug resistance of pathogenic bacteria in patients with incision infections were analyzed.Results Among the 3867 surgical patients,310(8.02%)had incision infections,among them,orthopedic infections were more common,with 103 cases(33.23%);among the infected sites,181 cases(58.39%)had superficial incision infections and 129 cases(41.61%)had deep infections;a total of 492 pathogenic bacteria were isolated,including 273 Gram negative bacteria(55.49%),201 Gram positive bacteria(40.85%),and 18 fungi(3.66%);among Gram negative bacteria,Klebsiella pneumoniae had strong resistance to ampicillin and ciprofloxacin,Pseudomonas aeruginosa had strong resistance to ampicillin and cefepime,and Escherichia coli had strong resistance to ampicillin and ciprofloxacin;among Gram positive bacteria,Staphylococcus epidermidis had strong resistance to erythromycin and gentamicin,Enterococcus faecalis had strong resistance to vancomycin,and Staphylococcus aureus had strong resistance to penicillin,tetracycline,and erythromycin;Candida albicans had strong resistance to amphotericin B;Candida tropicalis had strong resistance to fluconazole.Conclusion Timely and accurate identification of the distribution and types of pathogenic bacteria,and rational selection of antibiotics based on their drug resistance can effectively prevent and control incision infections in surgical patients.

关 键 词：外科手术 切口感染 病原菌 耐药性 

分 类 号：R44[医药卫生—诊断学]