胃肠肿瘤术后切口感染病原菌监测与预防性抗菌药物的选择分析

发布时间：2018-05-03 10:34

本文选题：胃肠肿瘤术 + 切口感染　；参考：《中华医院感染学杂志》2017年14期

【摘要】：目的统计分析胃肠肿瘤患者术后切口感染病原菌分布与耐药性监测数据,探讨预防使用抗菌药物的选择,以降低患者术后切口感染,提高手术质量。方法对医院2014年1月-2016年1月行手术治疗的525例胃肠肿瘤患者临床资料进行分析,收集术后切口感染患者的实验室检测、病原菌培养、分离、鉴定及药敏数据,整理分析胃肠肿瘤术后切口感染病原菌的分布情况及主要病原菌对常用抗菌药物的耐药性,结合胃肠肿瘤术患者的临床特点,探讨胃肠道肿瘤术患者围术期预防性抗菌药物的选择方案。结果 525例胃肠道手术患者切口分泌物中36例患者病原菌培养阳性,切口感染率6.86%,36份标本共检出42株病原菌,其中革兰阳性菌32株占76.19%,革兰阴性菌7株占16.67%,真菌3株占7.14%;金黄色葡萄球菌、化脓性链球菌、表皮葡萄球菌对头孢唑林、头孢拉定耐药率50%,而对替考拉宁、头孢噻吩、头孢氨苄、利奈唑胺、亚胺培南、美罗培南有较高的敏感性;大肠埃希菌、铜绿假单胞菌对替考拉宁、头孢噻吩有较高的耐药率50%,对氨苄西林、头孢曲松、阿莫西林、亚胺培南、美罗培南敏感性较高;患者经敏感抗菌药物治疗后,感染均得到有效控制。结论定期总结胃肠肿瘤术切口感染病原菌分布及药敏性数据,合理应用抗菌药物,延缓院内病原菌耐药性发展进程,以降低胃肠肿瘤患者术后切口感染率。
[Abstract]:Objective to analyze the distribution of pathogenic bacteria and drug resistance monitoring data of postoperative incision infection in patients with gastrointestinal neoplasms, and to explore the choice of antimicrobial agents in order to reduce postoperative wound infection and improve the quality of operation. Methods the clinical data of 525 patients with gastrointestinal neoplasms treated by surgical treatment from January 2014 to January 2016 were analyzed. The data of laboratory examination, pathogen culture, isolation, identification and drug sensitivity of postoperative incision infection patients were collected. The distribution of pathogenic bacteria of incision infection after operation of gastrointestinal neoplasms and the resistance of main pathogens to common antimicrobial agents were analyzed, and the clinical characteristics of patients with gastrointestinal neoplasms were analyzed. To explore the choice of prophylactic antimicrobial agents in patients with gastrointestinal neoplasms during perioperative period. Results 36 of 525 cases of incision secretion were positive for pathogenic bacteria culture. The infection rate of incision was 6.86%. 42 strains of pathogenic bacteria were detected in 36 specimens. Among them, 32 strains of Gram-positive bacteria accounted for 76.19%, 7 strains of Gram-negative bacteria accounted for 16.67%, 3 strains of fungi accounted for 7.14.The resistance rate of Staphylococcus aureus, Streptococcus pyogenes, Staphylococcus epidermidis to cefazolin and cefradine was 50%, while to teicoplanin and cefthiophene, Cefalexin, linazolamine, imipenem, meropenem have high sensitivity, Escherichia coli, Pseudomonas aeruginosa have a higher resistance to teicoplanin, cefthiophene has a higher drug resistance rate of 50, ampicillin, ceftriaxone, amoxicillin, Imipenem and meropenem were highly sensitive and infection was effectively controlled after treatment with sensitive antibiotics. Conclusion the data of pathogenic bacteria distribution and drug sensitivity of incision infection in gastrointestinal neoplasms are summarized periodically, and the rational use of antimicrobial agents to delay the development of drug resistance of pathogens in hospital, so as to reduce the incision infection rate in patients with gastrointestinal tumor.
【作者单位】：河南科技大学第一附属医院制剂室;河南科技大学第一附属医院门诊药房;河南科技大学第一附属医院住院药房;
【分类号】：R735

【相似文献】