摘要
目的探讨宫腔镜术后盆腔感染病原菌耐药性与影响因素。方法回顾性分析温州市中西医结合医院2016年2月-2018年10月收治的1 026例宫腔镜手术患者的临床资料,分析患者的临床资料、术后盆腔感染情况,对盆腔感染患者病原菌及耐药性进行分析,归纳宫腔镜术后盆腔感染的影响因素。结果术后盆腔感染40例,感染率为3.90%(40/1 026);共检出58株病原菌,其中革兰阴性菌38株占65.52%,以大肠埃希菌和肺炎克雷伯菌为主;革兰阳性菌17株占29.31%,以金黄色葡萄球菌为主;真菌3株占5.17%;主要革兰阴性菌对头孢唑林、头孢曲松、头孢哌酮、头孢他啶、左氧氟沙星、阿莫西林、磺胺甲噁唑/甲氧苄啶等药物耐药率较高,对亚胺培南、呋喃妥因等药物较敏感;主要革兰阳性菌对青霉素、红霉素、苯唑西林、环丙沙星、氨苄西林、左氧氟沙星等药物耐药率较高,对利奈唑胺、米诺环素、万古霉素较敏感;合并糖尿病、手术时间是宫腔镜手术患者术后盆腔感染的影响因素(P<0.05);预防性使用抗菌药物是盆腔感染的保护因素(P<0.05)。结论宫腔镜术后盆腔感染病原菌可表现为多种药物耐药,临床上可通过控制合并症、预防性抗菌药物使用及缩短手术时间等措施进行盆腔感染的预防。
OBJECTIVE To investigate the drug resistance and influencing factors of pathogenic bacteria in pelvic infection after hysteroscopy. METHODS The clinical data of 1 026 patients undergoing hysteroscopic surgery in Wenzhou Integrated Traditional Chinese and Western Medicine Hospital from Feb. 2016 to Oct. 2018 were retrospectively analyzed. The clinical data of patients and status of postoperative pelvic infection was also analyzed. The pathogenic bacteria and drug resistance of patients with pelvic infection were analyzed, and the influencing factors of pelvic infection after hysteroscopic surgery were summarized. RESULTS There were 40 cases with pelvic infection after surgery, with an infection rate of 3.90%(40/1 026). A total of 58 strains of pathogenic bacteria were detected, of which 38 strains of Gram-negative bacteria accounted for 65.52%, mainly Escherichia coli and Klebsiella pneumoniae;17 strains of Gram-positive bacteria accounted for 29.31%, mainly Staphylococcus aureus;and 3 strains of fungi accounted for 5.17%. The main Gram-negative bacteria had a higher drug resistance rate to cefazolin, ceftriaxone, cefoperazone, ceftazidime, levofloxacin, amoxicillin and sulfamethoxazole/methoxadine, and they were more sensitive to imipenem and nitrofurantoin. The main Gram-positive bacteria were resistant to penicillin, erythromycin, oxacillin, ciprofloxacin, ampicillin and levofloxacin, and were more sensitive to linezolid, minocycline and vancomycin. Diabetes and operation time were the influencing factors of postoperative pelvic infection in patients with hysteroscopic surgery(P<0.05), while preventive use of antibiotics was a protective factor(P<0.05). CONCLUSION There was a certain risk of pelvic infection after hysteroscopic surgery, and the pathogenic bacteria were resistant to multiple drugs. Clinically, pelvic infection could be prevented through controlling comorbidities, prophylactically using antibiotics and shortening the operation time.
作者
陈游沓
高洁
甘文
CHEN You-ta;GAO Jie;GAN Wen(Wenzhou Integrated Traditional Chinese and Western Medicine Hospital,Wenzhou,Zhejiang 325008,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第19期3011-3015,共5页
Chinese Journal of Nosocomiology
基金
浙江省自然科学基金资助项目(LY16H160002)。
关键词
宫腔镜
盆腔感染
病原菌
耐药性
影响因素
Hysteroscopy
Pelvic infection
Pathogen
Drug resistance
Influencing factor
