摘要
目的探讨外科手术切口感染的病原菌分布及耐药性,旨在为防治外科手术术后切口感染提供参考。方法回顾性分析2 478例外科实施手术患者临床资料,分析引起切口感染的病原菌分布及耐药性。结果 2 478例手术患者术后发生切口感染者78例,感染率为3.15%;切口局部分泌物病原菌培养阳性率73.08%,共分离出病原菌64株,其中革兰阴性菌39株占60.94%、革兰阳性菌23株占35.94%、真菌2株占3.13%;革兰阴性菌对氨苄西林、头孢唑林、氨苄西林/舒巴坦、头孢曲松耐药率较高,≥50.0%,大肠埃希菌对亚胺培南、哌拉西林/他唑巴坦、阿米卡星、呋喃妥因耐药率较低,≤25.00%,铜绿假单胞菌对亚胺培南、氨曲南、阿米卡星、头孢吡肟、左氧氟沙星耐药率较低,≤22.22%,肺炎克雷伯菌对哌拉西林/他唑巴坦、亚胺培南、氨曲南耐药率较低,≤33.33%;革兰阳性菌对头孢唑林、环丙沙星、青霉素G、克拉霉素耐药率较高,≥50.0%,金黄色葡萄球菌对分呋喃妥因、万古霉素、莫西沙星、左氧氟沙星、氨苄西林/舒巴坦耐药率较低,≤45.45%,表皮葡萄球菌对呋喃妥因、万古霉素、莫西沙星、左氧氟沙星、氨苄西林/舒巴坦耐药率较低,≤37.50%。结论引起外科手术切口感染的病原菌以革兰阴性菌为主,病原菌对临床常用抗菌药物耐药性较高,工作中应予以重视。
OBJECTIVE To explore the distribution and drug resistance of pathogens causing surgical incision infections so as to provide guidance for prevention of the postoperative incision infections. METHODS The clinical data of 2 478 patients who underwent surgery were retrospectively analyzed, then the distribution and drug resistance of the pathogens causing incision infections were analyzed. RESULTS Of the 2 478 patients undergoing surgery, the postoperative incision infections occurred in 78 cases with the infection rate of 3.15 %. 73.08 % of the incision local secretions were cultured positive; a total of 64 strains of pathogens have been isolated, including 39 （60. 94%） strains of gram-negative bacteria, 23 （35.94%） strains of gram-positive bacteria, and 2 （3.13%） strains of fungi.The drug resistance rates of the gram-negative bacteria to ampicillin, cefazolin, ampicillin-sulbactam, and ceftriax- one were no less than 50.0%; the drug resistance rates of the Escherichia coli to imipenem, piperacillin-tazobac- tam, amikacin, and nitrofurantoin were no more than 25.00% ; the drug resistance rates of the Pseudomonas aeruginosa to imipenem, aztreonam, amikacin, cefepime, and levofloxacin were no more than 22.22% ; the drug resistance rates of the Klebsiella pneumoniae to piperacillin-tazobactam, imipenem, and aztreonam were no more than 33.33 %. The drug resistance rates of the gram-positive bacteria to cefazolin, ciprofloxacin, penicillin G, and clindamycin were no less than 50.0% the drug resistance rates of the Staphylococcus aureus to nitrofurantoin, vancomycin, moxifloxacin, levofloxacin, and ampicillin-sulbactam were no more than 45.45 %; the drug resistance rates of the Staphylococcus epidermidis to nitrofurantoin, vancomycin, moxifloxacin, levofloxacin, and ampicil- lin-sulbactam were no more than 37.50%. CONCLUSION The gram-negative bacteria are the predominant patho- gens causing the surgical incision infections. The pathogens are highly resistant to the commonly used antibiotics,which should be at
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第10期2517-2519,共3页
Chinese Journal of Nosocomiology
基金
台州市科技计划基金资助项目(100KY01)
关键词
外科手术
切口感染
病原菌
耐药性
Surgery
Incision infection
Pathogen
Drug resistance
