摘要
目的分析普外科住院患者术后切口感染的相关因素及常见病原菌分布与耐药性,为预防治疗切口感染合理应用抗菌药物提供依据。方法选择2010年5月-2014年5月于普外科住院的460例患者临床资料,分析患者切口感染的相关因素、感染病原菌分布及药敏试验结果。结果 460例患者发生术后切口感染44例,感染率为9.57%;高龄、急性手术、合并有基础糖尿病、手术时间较长、Ⅱ类以上手术切口、术中出血量大的患者手术切口感染率较高,差异有统计学意义(P<0.05);术后切口感染患者共检出病原菌32株,其中革兰阴性菌18株占56.25%,革兰阳性菌12株占37.50%,真菌2株占6.25%;主要革兰阴性菌对头孢唑林、氨苄西林的耐药率均>80.00%,主要革兰阳性菌对万古霉素、克林霉素的耐药率均≤40.00%。结论高龄、急性手术、合并有基础糖尿病、手术时间较长、Ⅱ类以上手术切口、术中出血量大为患者术后切口感染的危险因素,可早期经验性的应用抗菌药物以预防术后切口感染。
OBJECTIVE To analyze the postoperative wound infection related factors of patients in department of general surgery and the drug resistance of pathogens so as to provide references for the rational use of antibiotics when treating wound infections .METHODS The clinical data of 460 cases of patients were selected from May 2010 to May 2014 of the general surgery in our hospital .The relevant factors of wound infection in patients and bacteri‐al distribution and pathogenic susceptibility test results were analyzed .RESULTS A total of 44 cases appeared post‐operative wound infection of the 460 cases and the infection rate was 9 .57% .Results found that older patients , and those with acute surgeries ,basis diabetes ,long surgery time ,type Ⅱ or more serious operative incision and large quantity of bleeding during operations were more susceptible and the differences were significant （P〈0 .05） . Totally 32 strains of pathogens were detected ,including 18 strains of gram‐negative bacteria （56 .25% ） and 12 strains of gram‐positive bacteria ,accounting for 37 .50% and two fungi ,accounting for 6 .25% .Gram‐negative bacteria were mainly resistant to cefazolin and ampicillin with the drug resistance rate over 80 .00% .And main gram‐positive bacteria were sensitive to vancomycin and clindamycin with the drug resistance rate less than 40 .00% .CONCLUSION Age ,acute surgery ,basic diabetes ,long operation time ,typeⅡ or more serious incision , large quantity of blood loss volume are risk factors for postoperative wound infection ,and early empirical antibiotic application can prevent the infection .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第19期4483-4485,共3页
Chinese Journal of Nosocomiology
基金
江苏省自然科学基金资助项目(BK20140343)
关键词
普外科
切口感染
病原菌
耐药性
General Surgery
Wound infection
Pathogen
Drug resistance
