腹股沟疝无张力修补术后医院感染的病原菌分布特征与耐药性分析

发布时间：2019-05-14 09:18

【摘要】：目的调查医院腹股沟疝无张力修补术后患者医院感染病原菌种类,分析病原菌的分布及耐药性,为临床该类手术感染的早期预防和术后治疗方案提供策略。方法收集2014年6月~2016年6月在医院行腹股沟疝无张力修补术患者800例,对术后感染患者采集感染部位分泌物进行细菌培养和耐药性分析。结果 800例腹股沟疝无张力修补术患者共发生术后医院感染35例,感染率为4.38%,感染部位有切口感染、泌尿系统感染以及呼吸系统感染。35例医院感染患者脓液培养获得病原菌69株,革兰阳性菌43株,占62.32%,革兰阴性菌25株,占36.23%。金黄色葡萄球菌、肺炎链球菌、表皮葡萄球菌对青霉素和磺胺甲恶唑/甲氧苄啶耐药性高,铜绿假单胞菌对头孢他啶、亚胺培南和阿米卡星均有较高的敏感性,耐药率均较低;鲍曼不动杆菌对临床常用的抗菌药物均表现出高度的耐药性;肺炎克雷伯菌及大肠埃希菌对头孢他啶、亚胺培南、磺胺甲恶唑/甲氧苄啶以及氨苄西林均敏感,耐药率均较低。结论医院腹股沟疝无张力修补术后患者医院感染病原菌感染以革兰阳性菌等为主,病原菌对不同抗菌药物表现出不同耐药性,耐药情况有普遍加强的趋势,该类临床手术应在治疗前予以联合抗菌用药,术后有针对性的及时调整,预防术后医院感染的发生。
[Abstract]:Objective to investigate the types of pathogenic bacteria of hospital infection after tension-free repair of inguinal hernia, and to analyze the distribution and drug resistance of pathogenic bacteria, so as to provide strategies for early prevention and postoperative treatment of this kind of surgical infection. Methods 800 patients undergoing tension-free repair of inguinal hernia from June 2014 to June 2016 were collected. The secretions from infected patients were collected for bacterial culture and drug resistance analysis. Results there were 35 cases of postoperative hospital infection in 800 patients with inguinal hernia tension-free repair, the infection rate was 4.38%. The infection site had incision infection. 69 strains of pathogenic bacteria, 43 strains of Gram-positive bacteria (62.32%) and 25 strains of Gram-negative bacteria (36.23%) were obtained from 35 patients with hospital infection. Staphylococcus aureus, Streptococcus pneumoniae and Staphylococcus epidermidis were highly resistant to penicillin and sulfamethoxazole / trimethoprim, and Pseudomonas aeruginosa was highly sensitive to ceftazidime, imipenem and amikacin, and the drug resistance rate was low. Acinetobacter baumannii was highly resistant to antibiotics commonly used in clinic, and Klebsiella pneumoniae and Escherichia coli were sensitive to ceftazidime, imipenem, sulfamethoxazole / trimethoprim and ampicillin, and the resistance rate was low. Conclusion Gram-positive bacteria are the main pathogenic bacteria in hospital infection after tension-free repair of inguinal hernia. The pathogens show different drug resistance to different antibiotics, and the drug resistance tends to strengthen generally. This kind of clinical operation should be combined with antibiotics before treatment, and timely adjustment should be made after operation to prevent the occurrence of postoperative hospital infection.
【作者单位】：平顶山市第一人民医院普外三科;
【分类号】：R656.21

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