摘要
目的回顾性分析2017年1月1日-2022年12月31日某医院的产妇产褥感染影响因素、病原菌分布特征与耐药性。方法选取某医院2017年-2022年产科的500例产妇进行回顾性分析,统计产妇产褥感染发生率,并根据感染情况分为感染组和未感染组,收集产妇的一般资料并分析产褥感染影响因素,采集宫颈、阴道、手术切口分泌物与血清作为细菌鉴定、药敏分析的样本,分析病原菌种类、分布情况及其常用抗菌药的耐药性。结果产褥感染45例,感染率为9.00%,主要感染部位包括会阴部与手术切口,感染例数(感染发生率)分别是15(33.33%)、11(24.44%);对比未感染组,感染组妊娠并发症[223(49.01%)VS35(77.78%)]、产前贫血[234(51.43)VS33(73.33%)]、生殖道炎症[223(49.01%)VS30(66.67%)]、瘢痕子宫[215(47.25%)VS 31(68.89%)]、胎膜早破[209(45.93%)VS 32(71.11%)]、产后出血[265(58.24%)VS36(80.00%)]比例均显著升高,并且多因素Logistic回归分析以上因素均是产褥感染的独立危险因素(P<0.05);产妇产褥感染主要病原菌类型为革兰阴性菌,主要病原菌是E.coli、溶血性链球菌与S.aureus,占比依次为46.43%、14.29%、12.50%;E.coli对亚胺培南耐药率为0.00%,S.aureus、溶血性链球菌对美罗培南、万古霉素耐药率为0.00%,三种致病菌均对氨苄青霉素耐药率为100.00%。结论妊娠并发症等多种产科因素均会增加产褥感染风险,会阴部与手术切口是易感部位,革兰阴性菌是主要病原菌,以E.coli、溶血性链球菌与S.aureus为主并且均对氨苄青霉素有较高耐药性。
Objectives To conduct a retrospective analysis of puerperal infection influencing factors,pathogenic bacteria distribution characteristics and drug resistance in a hospital from January 1st,2017 to December 31st,2022.Methods A retrospective analysis was conducted on 500 cases of puerperal infection in the obstetric department of a hospital from 2017 to 2022.The incidence rate of puerperal infection was calculated,and the cases were divided into infected group and uninfected group according to the infection situation.General information of the puerperal infection was collected and influencing factors of puerperal infection were analyzed.The species and distribution of pathogenic bacteria and the resistance of common antibiotics were analyzed.Results(1)There were 45 cases of puerperal infections with an infection rate of 9.00%,and the main sites of infection included the perineum and surgical incisions,and the incidence of infection was 15(33.33%)and 11(24.44%),respectively;(2)comparing with the uninfected group,the infected group suffered from pregnancy complications[223(49.01)vs.35(77.78)],peripartum anemia[234(51.43)vs.35(33(73.33))],inflammation of reproductive tract[223(49.01)vs 3530(66.67)],scarred uterus[215(47.25)vs 31(68.89)],premature rupture of membranes[209(45.93)vs 32(71.11)],and postpartum hemorrhage[265(58.24)vs 36(80.00)]were significantly higher.And all of the above factors were independent risk factors for puerperal infections in multifactorial logistic regression analysis(P<0.05);(3)the main types of pathogens for maternal puerperal infections were gram-negative bacteria,and the main pathogens were E.coli,hemolytic streptococci and S.aureus,with the proportions of 46.43%,14.29%,and 12.50%in that order;the rate of E.coli resistance to Imipenem was 0.00%,and the rate of resistance to Imipenem was 0.00%,and the rate of resistance to Imipenem was 0.00%.E.coli was 0.00%resistant to imipenem,S.aureus and hemolytic streptococcus were 0.00%resistant to meropenem and vancomycin,and all the three pathogeni
作者
徐云
奚润梅
周琴
Xu Yun;Xi Runmei;Zhou Qin(Department of Obstetrics,Taizhou People's Hospital Affiliated to Nanjing Medical University,Taizhou 225300,Jiangsu Province,China)
出处
《中国病案》
2024年第4期106-109,共4页
Chinese Medical Record
基金
江苏省卫生计生委医学科研课题(20MSXM72)。
关键词
产妇
产褥感染
影响因素
病原菌
耐药性
Puerpera
Puerperal infection
Influencing factors
Pathogenic bacteria
Drug resistance
