会阴切开术助产分娩切口感染的病原菌特点与预防

发布时间：2018-05-22 07:26

  本文选题：会阴切开术 + 助产　； 参考：《中华医院感染学杂志》2017年11期

【摘要】：目的探究会阴切开术助产分娩切口感染的病原菌特点、危险因素及相关预防对策,为临床医师在对产妇切口感染的治疗与预防上提供一定参考依据。方法选择2012年3月-2015年12月在医院行会阴切开术的孕妇3 520例,采集切口感染产妇的标本进行病原学分布、药敏试验及感染的相关危险因素分析。结果 3 520例会阴切开术分娩产妇中,100例发生切口感染,感染率为2.8%,共检出病原菌109株,其中革兰阳性菌以金黄色葡萄球菌和链球菌属为主,革兰阴性菌以大肠埃希菌为主,真菌以白假丝酵母菌和光滑假丝酵母菌为主;药敏结果显示,革兰阳性菌中链球菌对青霉素耐药率为0,阴道加德纳菌对氨苄西林和甲硝唑高度敏感,但金黄色葡萄球菌对头孢类抗菌药物敏感性较低,特别是对头孢曲松和头孢吡肟的耐药率高达71.4%和85.7%;革兰阴性菌对目前临床常用抗菌药物相对敏感,特别是对庆大霉素和万古霉素高度敏感;多因素logistics分析结果发现,年龄40岁、体质量≥24kg/m~2、合并基础疾病、阴道检查次数≥4次、胎膜早破以及产程≥8h是导致会阴切开术后切口感染的独立危险因素。结论详细了解会阴切开术助产分娩切口感染的病原菌特点及感染的危险因素,并提出相应预防措施,对降低会阴切开术后切口感染率及降低病原菌感染和预防耐药菌株的产生有重要意义,值得临床推广。
[Abstract]:Objective to investigate the pathogenic bacteria characteristics, risk factors and related preventive measures of incision infection in parturient delivery after perineal incision, and to provide some references for clinicians in the treatment and prevention of incision infection in parturient. Methods from March 2012 to December 2015, 3 520 pregnant women undergoing perineal incision were collected for pathogenic distribution, drug sensitivity test and risk factors of infection. Results among 3 520 cases of parturient with vaginal incision, 100 cases of incision infection occurred, the infection rate was 2.8%. 109 strains of pathogenic bacteria were detected. Among them, Staphylococcus aureus and Streptococcus spp were dominant in Gram-positive bacteria, and Escherichia coli was the main type of Gram-negative bacteria. The main fungi were Candida albicans and Candida cerevisiae, and the susceptibility of Streptococcus to penicillin in Gram-positive bacteria was 0, and Gardnebacterium vaginalis was highly sensitive to ampicillin and metronidazole. But Staphylococcus aureus was less sensitive to ceftriaxone and cefepime, especially to ceftriaxone and cefepime. The multivariate logistics analysis showed that the age of 40 years old, the body weight 鈮，

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