摘要
目的探讨妇科恶性肿瘤患者术后医院感染的发生,并对病原菌分布及耐药性进行分析。方法选取2011年1月-2015年7月在医院接受手术治疗的妇科恶性肿瘤患者452例,病原菌的定量培养基菌种的鉴定均根据《全国临床检验操作规程》中与临床微生物学检验相关的规则,应用常规操作方法进行;MIC法进行药敏试验。结果 452例患者发生医院感染42例,感染率9.29%;医院感染的主要类型为切口和尿路感染,分别占47.62%和28.57%;检出病原菌118株,其中革兰阴性菌占72.04%,以大肠埃希菌、铜绿假单胞菌及鲍氏不动杆菌为主,革兰阳性菌占25.42%,以金黄色葡萄菌为主,真菌占2.54%;铜绿假单胞菌及鲍氏不动杆菌对≥3种抗菌药物的耐药率达50.00%;金黄色葡萄菌与表皮葡萄球菌对青霉素的耐药率均达到100.00%,对利福平及万古霉素的耐药率均为0。结论妇科恶性肿瘤患者术后医院感染的主要类型为切口和尿路感染居多,病原菌主要以革兰阴性菌为主,具有较高的耐药性,在治疗时应根据药敏试验结果合理使用抗菌药物。
OBJECTIVE To investigate the nosocomial infections in patients with gynecologic malignant tumor,and to analyze the distribution characteristics and drug resistance of pathogenic bacteria.METHODS Totally 452 cases of gynecologic malignancy who underwent surgical treatment during Jan.2011 to Jul.2015 were enrolled.Identification of pathogenic strains in quantitative culture medium was conducted using routine methods according to the national clinical laboratory procedures.The MIC method was used for drug sensitivity test.RESULTS Totally 42 patients among the 452 patients had nosocomial infections,the infection rate was 9.29%.The main types of nosocomial infections were wound infections and urinary tract infections accounting for 47.62% and 28.57%.Totally118 strains of pathogens were detected,including gram-negative bacteria（72.04%）dominated by Escherichia coli,Pseudomonas aeruginosa and Acinetobacter baumannii as well as gram-positive bacteria（25.42%）and fungi（2.54%）.Antimicrobial resistance rates of P.aeruginosaand A.baumannii to≥ 3drugs reached more than 50.00%.The resistance rates of Staphylococcus epidermidis and Staphylococcus aureus reached 100.00%to penicillin,but 0to rifampin and vancomycin.CONCLUSION Nosocomial infections in gynecologic postoperative patients with malignant tumor were mainly wound infections and urinary tract infections,the pathogenic bacteria were mainly gram-negative bacteria and have a high resistance.Antimicrobial agents should be selected rationally according to antimicrobial susceptibility test results.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第3期656-658,共3页
Chinese Journal of Nosocomiology
基金
贵州省科技厅联合基金资助项目(黔科合J字LKZ[2011]20)
关键词
恶性肿瘤
妇科
医院感染
病原菌
耐药性
Malignant tumor
Department of gynecology
Nosocomial infection
Pathogenic bacteria
Drug resistance
