宫颈癌根治术后泌尿系统感染患者的病原菌分布及耐药性分析

发布时间：2018-03-21 14:12

本文选题：宫颈癌根治术　切入点：医院感染　出处：《中华医院感染学杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的分析宫颈癌根治术后泌尿道感染患者的病原菌分布及耐药性,为医院感染预防控制工作提供客观依据。方法选取2013年3月-2016年8月314例行宫颈癌根治术患者为研究对象,对其术后泌尿系统感染病原菌分布及耐药性进行观察和分析。结果 314例行宫颈癌根治术患者中112例发生尿道感染,感染率为35.7%;共检出202株病原菌,其中革兰阴性菌、革兰阳性菌、真菌分别占61.0%、33.6%和5.4%,主要病原菌为大肠埃希菌、粪肠球菌、肺炎克雷伯菌、阴沟肠杆菌,分别占31.7%、15.3%、14.4%、10.9%;革兰阴性菌中大肠埃希菌对氨苄西林、左氧氟沙星、四环素、磺胺甲VA唑/甲氧苄啶、环丙沙星等耐药率较高,均85.0%,肺炎克雷伯菌对氨苄西林、呋喃妥因的耐药率较高,均60.0%,阴沟肠杆菌对氨苄西林、阿莫西林、头孢唑林等耐药率均为100.0%;未检出耐亚胺培南革兰阴性菌;革兰阳性菌中粪肠球菌对红霉素、四环素、利福平、氯霉素的耐药率较高,均50.0%,表皮葡萄球菌对青霉素G、左氧氟沙星、庆大霉素的耐药率较高,均75.0%,屎肠球菌对左氧氟沙星、呋喃妥因、氨苄西林、四环素等耐药率较高,均75.0%,未检出耐万古霉素革兰阳性菌。结论宫颈癌根治术后泌尿系统感染的病原菌分布和耐药性均具有一定的特征,临床医师应对其给予高度重视、密切监控和有效干预,以提高医院感染预防控制效果。
[Abstract]:Objective to analyze the distribution and drug resistance of pathogenic bacteria in patients with urinary tract infection after radical resection of cervical cancer, and to provide an objective basis for the prevention and control of nosocomial infection. Results 112 cases of urethral infection occurred in 314 cases of cervical cancer radical operation, the infection rate was 35.70.202 strains of pathogenic bacteria were detected, among which Gram-negative bacteria were detected. Gram-positive bacteria, fungi accounted for 33.6% and 5.4%, respectively. The main pathogens were Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae, Enterobacter cloacae, respectively. The resistance rates of sulfamethazol / trimethoprim and ciprofloxacin to ampicillin and furantoin were higher than those of Klebsiella pneumoniae, and the resistance rates of Enterobacter cloacae to ampicillin and amoxicillin were higher. The resistant rates of cefazolin and so on were 100.0%, no imipenem resistant gram-negative bacteria were detected, and Enterococcus faecalis showed higher resistance to erythromycin, tetracycline, rifampicin and chloramphenicol in Gram-positive bacteria, and Staphylococcus epidermidis was resistant to penicillin G and levofloxacin. The resistance rate of gentamicin to levofloxacin, furantoin, ampicillin and tetracycline was higher than that of Enterococcus faecium, and the resistance rate of Enterococcus faecium to levofloxacin, furantoin, ampicillin and tetracycline was higher. No vancomycin resistant gram-positive bacteria were detected. Conclusion the distribution of pathogens and drug resistance of urinary system infection after radical resection of cervical cancer have some characteristics. Clinicians should attach great importance to them, monitor them closely and intervene effectively. To improve the effect of nosocomial infection prevention and control.
【作者单位】：武汉市妇女儿童医疗保健中心妇产科;
【基金】：湖北省卫计委基金资助项目(WJ2015MB246)
【分类号】：R737.33;R691.3

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