摘要
目的分析外科手术切口感染病原菌的分布及耐药情况。方法选取2012年6月—2017年6月白银市第一人民医院收治的外科手术后切口感染患者246例,对切口分泌物及深部分泌物进行病原菌培养及药敏试验,并统计分析其检测结果。结果 246例患者切口感染中共分离出病原菌278株,其中大肠埃希菌占比最高,其次为金黄色葡萄球菌。革兰阴性菌以大肠埃希菌、阴沟肠杆菌、铜绿假单胞菌为主,其对头孢他啶、氨苄西林、氨苄西林/舒巴坦、庆大霉素、环丙沙星、复方新诺明耐药率较高,对哌拉西林/他唑巴坦、亚胺培南、头孢哌酮/舒巴坦、丁胺卡那霉素耐药率较低。革兰阳性菌中以金黄色葡萄球菌和表皮葡萄球菌为主,金黄色葡萄球菌耐药率较低,敏感率较高;而表皮葡萄球菌对红霉素、青霉素G、苯唑西林、复方新诺明、克林霉素耐药率较高,敏感率较低,对庆大霉素、利奈唑胺、万古霉素的敏感率较高。结论对于外科手术切口感染患者,临床可首选对哌拉西林/他唑巴坦、亚胺培南、头孢哌酮/舒巴坦、丁胺卡那霉素、庆大霉素、利奈唑胺、万古霉素等敏感性较高的药物,有助于预防外科手术切口感染,并取得良好的治疗效果。
Objective To analyze the the distribution and drug resistance of pathogenic bacteria in surgical incision infection.Methods A total of 246 cases of patients with surgical incision infection were admitted from June 2012 to June 2017 in the First People＇s hospital of Baiyin.Pathogenic bacteria culture and drug susceptibility test were carried out on incision secretion and deep secretion,and the results were analyzed statistically. Results A total of 278 strains of pathogenic bacteria were isolated from 246 patients with infection,Escherichia coli accounted for the highest proportion,followed by Staphylococcus aureus. Gram-negative bacteria were mainly for Escherichia coli,Enterobacter cloacae and Pseudomonas aeruginosa,which had higher resistance rates to ceftazidime,ampicillin,ampicillin/sulbactam,gentamicin,ciprofloxacin and compound bromide,and with lower resistance rate to piperacillin/tazobactam,imipenem,cefoperazone/sulbactam and amikacin. Staphylococcus aureus and Staphylococcus epidermidis were the main Gram-positive bacteria. Staphylococcus aureus had lower drug resistance and higher sensitivity. Staphylococcus epidermidis had high resistance to erythromycin,penicillin G,oxacillin,compound trimethoprim and clindamycin,and low sensitivity to gentamicin,linezolid and vancomycin.Conclusion For surgical incision infection patients,the first choice is piperacillin/tazobactam,imipenem,cefoperazone/sulbactam,amikacin,gentamicin,linezolid,vancomycin and other sensitive drugs,which can help prevent surgical incision infection,and achieve good therapeutic effect.
作者
杨小兰
胡增军
贾婧
YANG Xiao-lan;HU Zeng-jun;JIA Jing(Department of Inspection,the First People＇s hospital of Baiyin,Baiyin 730900,China)
出处
《临床合理用药杂志》
2018年第30期24-25,27,共3页
Chinese Journal of Clinical Rational Drug Use
关键词
外科手术
伤口感染
病原菌
Surgery
Wound infection
Pathogenic bacteria
