阑尾切除术后腹腔感染的病原学

发布时间：2019-03-24 14:04

【摘要】：目的了解阑尾炎患者行阑尾切除术后腹腔感染的病原学特点。方法回顾性分析2013年1月—2015年12月某院行阑尾切除术患者的临床病历资料,对腹腔感染患者的病原学特点、治疗及预后情况进行分析。结果共调查阑尾切除术患者431例,38例术后出现腹腔感染,发病率为8.82%。检出病原菌36株,其中革兰阴性菌34株(94.44%),主要为大肠埃希菌(29株,80.55%);革兰阳性菌2株(5.56%),金黄色葡萄球菌和鸟肠球菌各1株。29株大肠埃希菌对临床常用的抗菌药物如阿莫西林、哌拉西林、替卡西林、头孢呋辛、头孢他啶、头孢噻吩的耐药率为72.41%~93.10%,未检出对哌拉西林/他唑巴坦、美罗培南、亚胺培南及阿米卡星耐药的菌株。结论大肠埃希菌是阑尾切除术后腹腔感染最主要的病原菌,且对大多常用抗菌药物的耐药率高,可选用哌拉西林/他唑巴坦、阿米卡星或碳青霉烯类抗生素进行治疗。
[Abstract]:Objective to investigate the etiological characteristics of abdominal infection after appendectomy in patients with appendicitis. Methods the clinical data of patients undergoing appendectomy from January 2013 to December 2015 were retrospectively analyzed. The etiological characteristics, treatment and prognosis of patients with abdominal infection were analyzed. Results A total of 431 cases of appendectomy were investigated, 38 cases had abdominal infection after appendectomy, the incidence rate was 8.82%. 36 strains of pathogenic bacteria were detected, of which 34 strains (94.44%) were Gram-negative, and the main strains were Escherichia coli (29 strains, 80.55%). Two strains (5.56%) were gram-positive, one strain was Staphylococcus aureus and one strain was enterococci. 29 strains of Escherichia coli were resistant to antibiotics such as amoxicillin, piperacillin, teicacillin, cefuroxime and ceftazidime. The resistance rate of ceftazobin to piperacillin / tazobactam, meropenem, imipenem and amikacin was 72.41% / 93.10%, and no strains were found to be resistant to piperacillin / tazobactam, imipenem and amikacin. Conclusion Escherichia coli is the main pathogen of abdominal infection after appendectomy, and the resistance rate to most commonly used antibiotics is high. Piperacillin / tazobactam, amikacin or carbapenem antibiotics can be used for treatment.
【作者单位】：邵阳市新宁县人民医院;长沙卫生职业学院招生和就业处;湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院;
【分类号】：R656.8

【参考文献】