华西医学

华西医学

妇科患者术后手术部位感染病原菌分布与药物敏感性分析

查看全文

目的 了解妇科手术合并手术部位感染患者的病原菌分布和耐药性特点,为预防和治疗提供依据。 方法 收集 2010 年 1 月—2015 年 5 月在四川大学华西第二医院妇科住院手术且发生手术切口感染的 70 例患者资料,对其送检标本病原菌种类及药物敏感性(药敏)试验结果进行分析。 结果 共检出 72 株病原菌,其中革兰阴性菌 36 株(50.0%),主要为大肠埃希菌(36.1%)和阴沟肠杆菌(5.6%);革兰阳性菌 36 株(50.0%),主要为金黄色葡萄球菌(18.1%)、表皮葡萄球菌(12.5%)和粪肠球菌(8.3%)。大肠埃希菌对氨苄西林、头孢曲松、庆大霉素敏感性较低,耐药率分别是 76.9%、61.5%、61.5%;金黄色葡萄球菌对青霉素 G、克林霉素、红霉素敏感性较低,耐药率分别是 92.3%、69.3%、61.5%;表皮葡萄球菌对红霉素、青霉素 G、环丙沙星敏感性较低,耐药率分别是 88.9%、77.8%、77.8%。未检出耐碳青霉烯类革兰阴性菌和耐万古霉素革兰阳性菌。 结论 术后手术部位感染是最常见的院内感染,该院妇科手术切口感染病原菌以大肠埃希菌、金黄色葡萄球菌、表皮葡萄球菌、粪肠球菌为主,对目前常用抗菌药物均产生不同程度耐药性,因此应更重视细菌分离和药敏试验,为抗菌药物合理运用提供科学依据,提高治疗医院感染的有效率。

Objective To probe the distribution and drug resistance of pathogens causing surgical site infection in patients after gynecologic operation, and provide reference for prevention and treatment. Methods Seventy patients with incision infection after gynecologic operation in West China Second University Hospital of Sichuan University from January 2010 to May 2015 were selected. Species of the pathogens from the submitted specimens and the results of the drug susceptibility testing were analyzed. Results Seventy-two strains of pathogens were isolated, including 36 strains (50.0%) of Gram-negative (G) bacteria and 36 strains (50.0%) of Gram-positive (G+) bacteria. The main G bacteria were Escherichia coli (36.1%) and Enterobacter cloacae (5.6%); the main G+ bacteria were Staphylococcus aureus (18.1%), Staphylococcus epidermidis (12.5%), and Enterococcus faecalis (8.3%). Escherichia coli showed low sensitivities to ampicillin, ceftriaxone, and gentamicin, with resistance rates of 76.9%, 61.5%, and 61.5%, respectively. Staphylococcus aureus showed low sensitivities to penicillin G, clindamycin, and erythromycin, with resistance rates of 92.3%, 69.2%, and 61.5%, respectively. Staphylococcus epidermidis showed low sensitivities to erythromycin, penicillin G, and ciprofloxacin, with resistance rates of 88.9%, 77.8%, and 77.8%, respectively. No carbapenem-resistant G bacteria or vancomycin-resistant G+ bacteria were detected. Conclusion Postoperative surgical site infection is the most common nosocomial infection. The main bacteria related to postoperative incision infection in the gynecology department of the hospital are Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, and Enterococcus faecalis, which become resistant to common antibiotics currently. Therefore more attention should be paid to bacterial isolation and drug susceptibility test results for rational use of antimicrobial drugs and effectiveness of the treatment to nosocomial infection.

关键词: 妇科手术; 手术部位感染; 病原菌; 药物敏感性试验

Key words: Gynecologic operation; Surgical site infection; Pathogen; Drug susceptibility test

引用本文: 欧洋华, 陈岑, 陈静, 周伟, 旷凌寒, 江咏梅. 妇科患者术后手术部位感染病原菌分布与药物敏感性分析. 华西医学, 2018, 33(3): 294-297. doi: 10.7507/1002-0179.201801189 复制