高龄产妇术后尿道及切口感染特点及危险因素分析

发布时间：2019-06-29 14:24

【摘要】：目的研究高龄产妇术后尿道和切口感染临床特点及危险因素预防对策。方法选择2012年8月-2015年12月在医院行剖宫产的高龄产妇460例,对于出现感染的高龄产妇进行病原菌和药敏分析,同时详细记录460例患者的临床资料进行相关单因素及多因素logistic分析。结果从51例标本中共分离出病原菌84株,革兰阴性菌53株占63.10%,革兰阳性菌31株占36.90%;主要为大肠埃希菌、金黄色葡萄球菌和肠球菌属;病原菌对于目前临床常用抗菌药物均存在一定的耐药性,其革兰阴性菌对氨苄西林的耐药性最高达78.00%以上,其次为头孢类抗菌药物;而革兰阳性菌对于青霉素和氨苄西林有着较高的耐药性,耐药性在18.18%~73.30%之间,对于苯唑西林和替考拉宁有着较高的敏感性,耐药性为0;合并基础疾病、阴道检查次数、孕期并发症及手术时间是导致患者发生术后尿道和切口感染的独立危险因素(P0.05)。结论一方面严格各项无菌操作流程,同时还应对已出现感染的产妇做好病原菌和药敏试验的监测,同时还应针对高龄产妇发生感染的相关影响因素进行分析,并做好相应的预防措施。
[Abstract]:Objective to study the clinical characteristics and risk factors of postoperative urethral and incision infection in elderly parturients. Methods 460 elderly parturients who underwent cesarean section in hospital from August 2012 to December 2015 were selected to analyze the pathogenic bacteria and drug sensitivity of the infected elderly parturients. The clinical data of 460 patients were recorded in detail for univariate and multivariate logistic analysis. Results A total of 84 strains of pathogenic bacteria were isolated from 51 specimens, 53 strains of Gram-negative bacteria (63.10%) and 31 strains of Gram-positive bacteria (36.90%), mainly Escherichia coli, Staphylococcus aureus and Enterococci. The pathogens were resistant to antibiotics commonly used in clinic, and the resistance of Gram-negative bacteria to ampicillin was more than 78.00%, followed by cephalosporins. Gram-positive bacteria had high resistance to penicillin and ampicillin, between 18.18% and 73.30%, and higher sensitivity to oxacillin and teicoplanin, with drug resistance of 0. Combined with basic diseases, vaginal examination times, complications during pregnancy and operation time were independent risk factors for postoperative urethral and incision infection (P 0.05). Conclusion on the one hand, strict aseptic operation procedures, at the same time, we should monitor the pathogenic bacteria and drug sensitivity test of the infected parturients, at the same time, we should analyze the related influencing factors of the infection in the elderly parturients, and do a good job of preventive measures.
【作者单位】：海南医学院附属医院产科二病区;
【分类号】：R719.8

【相似文献】