产后盆腔炎患者病原菌分布及耐药性研究

发布时间：2018-02-03 08:58

本文关键词： 产后盆腔炎病原菌分布耐药性　出处：《中华医院感染学杂志》2017年24期 　论文类型：期刊论文

【摘要】：目的分析产后盆腔炎(PID)患者的病原菌分布特点和耐药情况的研究,探讨产后患者盆腔炎感染特征。方法回顾性选取在2015年3月-2016年7月期间于医院妇产科明确诊断为盆腔炎的112例患者为研究对象,采集宫内分泌物进行菌株培养分离,并采用MicroScan walkAway-96全自动微生物菌种鉴定仪进行细菌鉴定和药敏试验,统计分析PID患者的病原菌鉴定结果及耐药性。结果 112例感染患者送检的分泌物样本中共检出病原菌97株,检出率为86.61%,其中革兰阴性菌68株占70.10%,革兰阳性菌22株占22.68%,真菌7株占7.22%;大肠埃希菌对诺氟沙星、庆大霉素和头孢替唑钠的耐药率较高,均50%,对头孢克肟和美罗培南的耐药率较低,均5%;肺炎克雷伯菌对诺氟沙星、庆大霉素和左氧氟沙星耐药率较高,均≥60%;金黄色葡萄球菌对青霉素、氨苄西林和克林霉素的耐药率较高,均70%。结论 PID是产后女性易感染疾病,其主要致病菌为革兰阴性菌,而美罗培南、头孢克肟及氟喹诺酮类抗菌药物对其有明确地抑菌作用,在临床治疗产后盆腔炎患者应根据细菌培养结果,能够合理使用抗菌药物,有效控制感染发展和降低耐药情况的产生。
[Abstract]:Objective to analyze the distribution and drug resistance of pathogenic bacteria in patients with postpartum pelvic inflammatory disease (PIDD). Methods from March 2015 to July 2016, 112 patients diagnosed as pelvic inflammatory disease in hospital gynecology and obstetrics department were selected retrospectively. Intrauterine secretions were collected for strain culture and isolation, and MicroScan walkAway-96 automatic microorganism identification instrument was used to identify bacteria and drug sensitivity test. Results 97 strains of pathogenic bacteria were detected in the secretion samples of 112 patients with PID, and the detection rate was 86.61%. Among them, 68 strains of Gram-negative bacteria accounted for 70.10%, 22 strains of Gram-positive bacteria accounted for 22.68% and 7 strains of fungi accounted for 7.22%. The resistance rate of Escherichia coli to norfloxacin, gentamycin and ceftiazole sodium was higher than that of cefixime and meropenem, and the resistance rate of Escherichia coli to norfloxacin, gentamycin and ceftiazole sodium was higher than that of cefixime and meropenem. The resistance rate of Klebsiella pneumoniae to norfloxacin, gentamicin and levofloxacin was higher than 60%. Staphylococcus aureus was resistant to penicillin, ampicillin and clindamycin, all of which were 70. Conclusion PID is susceptible to infection in postpartum women, and the main pathogenic bacteria are Gram-negative bacteria and meropenem. Cefixime and fluoroquinolones have a definite bacteriostatic effect on them. In clinical treatment of postpartum pelvic inflammatory disease patients should be able to use antibiotics reasonably according to the results of bacterial culture. Effectively control the development of infection and reduce the incidence of drug resistance.
【作者单位】：潍坊市益都中心医院产科;
【基金】：山东省医药卫生科技厅科研基金资助项目(2016WS0544)
【分类号】：R711.33
【正文快照】： 盆腔炎(PID)是育龄女性常见的妇科疾病[1],多因女性的盆腔生殖器官及周围组织发生炎性反应,而导致的盆腔腹膜产生炎症,病症可见子宫、输卵管和盆腔结缔组织等单个部位或者其他多个部位同时发病。根据临床统计[2-3],我国女性盆腔炎的发病率可达28%以上,其中发病人群以产后妇女

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