初产妇剖宫产手术切口感染病原菌分布及其药敏分析

发布时间：2018-03-04 19:36

本文选题：初产妇　切入点：剖宫产　出处：《实用预防医学》2016年11期 　论文类型：期刊论文

【摘要】：目的监测初产妇剖宫产手术切口感染病原菌分布,掌握近期药敏状况,为医院感染的防控提供参考。方法采集诸暨市妇幼保健院2012年1月-2015年3月剖宫产切口感染的初产妇62例切口分泌物,进行病原菌培养、鉴定及药敏试验。结果共培养鉴定出13种病原菌89株,以G-球菌为主(61株),占68.54%,前三位的病原菌分别为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌;其次是G+球菌(24株),占26.97%,前三位的病原菌分别是金黄色葡萄球菌、表皮葡萄球菌和溶血葡萄球菌;培养鉴定出4株直菌,占4.49%。分离到16株产超广谱β-内酰胺酶(ESBLs)大肠埃希菌,占病原菌的17.98%,占大肠埃希菌的53.33%。主要G-球菌除对美罗培南、亚胺培南高度敏感,对阿莫西林/克拉维酸、哌拉西林/他唑巴坦钠、替卡西林/克拉维酸较敏感外,对其它抗菌药物均存在不同程度的耐药,且显示出交叉耐药性;G+球菌对万古霉素、替考拉宁、利奈唑胺高度敏感,对庆大霉素等抗菌药物敏感性较高。结论初产妇剖宫产手术切口感染病原菌种类繁多,耐药性增强,提示临床一方面做好围术期感染的防控,另一方面加强抗生素应用的管理,降低切口感染率和遏制耐药菌的增长。
[Abstract]:Objective to monitor the distribution of pathogenic bacteria of incisional infection in cesarean section of primipara, and to know the recent drug sensitivity. Methods 62 cases of incisional secretion from January 2012 to March 2015 of cesarean section infection in Zhuji City Maternal and Child Health Hospital were collected and cultured. Results A total of 89 strains of 13 pathogens were identified, of which 61 were G- coccus, accounting for 68.54. The first three pathogens were Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae. The next were 24 strains (26.97%) of G cocci, the first three pathogens were Staphylococcus aureus, Staphylococcus epidermidis and Staphylococcus haemolyticus, and 4 strains (4.49%) were identified by culture. 16 strains of Escherichia coli producing extended-spectrum 尾 -lactamase (ESBLs) were isolated. In addition to meropenem, imipenem, amoxicillin / clavulanic acid, piperacillin / tazobactam sodium and ticacillin / clavulanic acid, the main G- cocci were highly sensitive to meropenem and imipenem, respectively, to amoxicillin / clavulanic acid, to piperacillin / tazobactam sodium, and to ticacillin / clavulanic acid. The resistance to other antimicrobial agents was different, and the cross resistance of G coccus was highly sensitive to vancomycin, teicoplanin and linazolamine. Conclusion there are many kinds of pathogenic bacteria in cesarean section incision infection in primiparous women, and the drug resistance is enhanced, which indicates that the prevention and control of infection in perioperative period should be done well in clinic, and the management of antibiotic application on the other hand should be strengthened on the one hand, and the prevention and control of infection in perioperative period on the other hand. Reduce incision infection rate and control the growth of drug-resistant bacteria.
【作者单位】：诸暨市人民医院输血科;诸暨市中医院检验科;诸暨市妇幼保健院;
【分类号】：R446.5;R719.8

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