腹部手术切口感染病原菌分布与耐药性分析及对策

发布时间：2018-01-03 08:22

本文关键词：腹部手术切口感染病原菌分布与耐药性分析及对策　出处：《中国卫生检验杂志》2016年22期 　论文类型：期刊论文

更多相关文章： 腹部手术 切口感染 病原菌 耐药性

【摘要】：目的探讨腹部手术切口感染的病原菌分布及耐药性,为临床选择合适的抗菌药物控制感染提供参考依据。方法回顾分析2011年-2015年本院普外科6 289例患者术后切口感染率、病原菌分布及药敏试验。结果 6 289例腹部手术患者发生切口感染263例,感染率为4.18%。感染率总体呈逐年下降趋势,其中后2年切口感染率明显低于前3年,差异有统计学意义(P0.05)。分离病原菌227株,其中革兰阴性菌137株,革兰阳性菌74株,真菌16株。革兰阴性菌主要为铜绿假单胞菌、大肠埃希菌和肺炎克雷伯菌,革兰阳性菌主要为葡萄球菌属和肠球菌属。革兰阴性菌对亚胺培南敏感,对加酶抑制剂复合抗菌药物耐药率均低于15%,革兰阳性菌对万古毒素和替考拉宁全部敏感,对亚胺培南较敏感,耐药率均10%。结论外科手术切口感染的病原菌多为多药耐药菌,临床应重视手术切口感染病原菌的监测,根据病原菌分布和耐药率的变化特点调整治疗方案,减少手术切口感染的发生率和耐药菌的产生。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria in abdominal incision infection. Methods from 2011 to 2015, the incision infection rate of 6 289 patients in general surgery department was retrospectively analyzed. Results 263 cases of incision infection occurred in 6 289 cases of abdominal surgery, the infection rate was 4.18%. The overall infection rate was decreasing year by year. The incision infection rate in the latter 2 years was significantly lower than that in the previous 3 years, and the difference was statistically significant (P 0.05). 227 strains of pathogenic bacteria were isolated, of which 137 were Gram-negative bacteria and 74 were Gram-positive bacteria. 16 strains of fungi were found. Gram-negative bacteria were mainly Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae. Gram-positive bacteria were mainly Staphylococcus and Enterococcus. Gram-negative bacteria were sensitive to imipenem. The resistance rates of Gram-positive bacteria to antiseptic agents were lower than 15. Gram-positive bacteria were all sensitive to venotoxin and teicoplanin, but sensitive to imipenem. Conclusion most of the pathogenic bacteria in surgical incision infection are multidrug resistant bacteria, and clinical attention should be paid to the monitoring of surgical incision infection pathogens. According to the distribution of pathogenic bacteria and the change of drug resistance rate, the treatment plan was adjusted to reduce the incidence of surgical incision infection and the production of drug-resistant bacteria.
【作者单位】：义乌中心医院普外科;杭州医学院基础医学部;
【基金】：浙江省卫生高层次创新人才培养工程项目(2012-241)
【分类号】：R619.3;R446.5
【正文快照】： 手术切口感染是外科手术常见并发症之一,腹部手术切口由于特定的解剖位置,术后切口感染率往往高于其他部位,特别是合并腹腔内穿孔、腹膜炎或急性肠梗阻等切口感染更易发生[1]。手术切口感染特别是多耐药菌株感染增加治疗难度,导致患者住院时间延长,给患者带来不必要的经济与精

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