摘要
目的分析消化道肿瘤患者术后切口感染的病原菌及耐药性,为消化道肿瘤患者术后感染的预防提供参考。方法选取2009年5月-2011年5月在医院行手术治疗的消化道肿瘤患者446例,对发生术后切口感染患者的切口病原菌分布及其耐药性进行回顾性分析。结果 446例患者术后有86例发生切口感染,感染率为19.28%;共检出72株病原菌,其中革兰阳性菌共21株,占29.17%,主要为粪肠球菌和金黄色葡萄球菌,分别占15.28%和11.11%;革兰阴性菌共51株,占70.83%,主要为大肠埃希菌、铜绿假单胞菌、阴沟肠杆菌、产气肠杆菌和肺炎克雷伯菌,分别占25.00%、16.67%、13.89%、6.94%和5.56%;主要病原菌对常用抗菌药物多药耐药,革兰阳性菌对青霉素类、氨基糖苷及喹诺酮类较敏感,其中以万古霉素敏感度最高,敏感率为100.0%;革兰阴性菌对亚胺培南最敏感,耐药率均<8.3%。结论应加强术后感染的监控,对外科切口感染病原菌分布及耐药性进行相关分析,以帮助临床医师制定适宜的治疗方案,从而降低消化道肿瘤患者术后切口感染的发生。
OBJECTIVE To analyze the pathogens causing postoperative incision refections in the patients with gastrointestinal cancer and explore the drug resistance so as to prevent the postoperative incision infections in the patients with gastrointestinal cancer. METHODS A total of 446 patients with gastrointestinal tumors who received surgery in the hospital from May 2009 to May 2011 were selected to analyze the distribution and drug resistance of the pathogens causing postoperative incision infections. RESULTS Totally 86 of 446 cases of patients caught incision infections after the surgery with the infection rate of 19.28 %. A total of 72 strains of pathogens were detected, including 21 （29. 17%）strains of gram-positive bacteria and 51 （70. 83%） strains of gram-negative bacteria. Enterococcus faecalis and Staphylococcus aureus were the predominant gram-positive bacteria, accounting for 15. 28% and 11. 11%, respectively% Escherichia colt, Pseudomona aeruginosa, Enterobacter cloacae , Enterobacter aerogenes and Klebsiella pneumoniae were dominant among the gram-negative bacteria, accounting for 25. 00%, 16. 67%, 13. 89%, 6. 9%, and 5. 56%, respectively. The main pathogens showed multidrug-resistant, the gram-positive bacteria were sensitive to penicillins, aminoglycosides and quinolones, the drug susceptibility rate to vancomycin was 100. 0%, and the gram-negative bacteria were more susceptible to imipenem with the drug resistance rate less than 8.3 %. CONCLUSION It is necessary to strengthen the monitoring of postoperative infections, analyze the distribution and drug resistance of the pathogens causing the surgical incision infections so as to help the clinicians formulate the appropriate treatment programs and reduce the incidence of postoperative incision infections in the patients with gastrointestinal cancer.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第10期2498-2500,共3页
Chinese Journal of Nosocomiology
关键词
消化道肿瘤
术后切口感染
耐药性
Gastrointestinal cancer
Postoperative incision infeetion
Drug resistance
