摘要
目的分析儿童医院外科手术后切口感染病原菌及耐药性情况,为预防和治疗术后感染提供科学依据。方法收集海南省妇女儿童医学中心外科手术后创口分泌物及脓液送检标本,采用VITEK 2 Compact全自动微生物药敏分析仪进行细菌培养鉴定和药敏试验,采用WHONET 5.6软件进行统计学分析。结果292例外科手术后切口感染患者的创口分泌物和脓液标本中共分离出169株病原菌,其中革兰氏染色阳性球菌占59.2%,主要为金黄色葡萄球菌;革兰氏染色阴性杆菌占33.7%,主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌;真菌占7.1%,主要为白色念珠菌。药敏结果方面,金黄色葡萄球菌多重耐药以苯唑西林敏感性实验作为标准,耐药率为48.3%,革兰氏染色阴性杆菌中大肠埃希菌对β-内酰胺类抗生素的耐药性略高,肺炎克雷伯菌对β-内酰胺类抗生素有较高的耐药性,铜绿假单胞菌和鲍曼不动杆菌对各类抗生素都较敏感。结论外科手术后切口感染以金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌为主,细菌耐药情况仍然比较严峻,合理的术前准备工作和有效的使用抗菌药物治疗尤为重要,应尽量减少或避免经验用药,同时应当加强抗生素使用的监管,杜绝滥用,以减少耐药菌株的产生。
Objective To analyze the distribution and drug resistance of pathogenic bacteria of postoperative incision infection in a Children’s hospital and provide scientific basis for prevention and treatment of postoperative infection.Methods Specimens of the incision secretions and pus after surgery in Hainan Women and Children’s Medical Center were collected.Bacterial culture identification and susceptibility testing were conducted by VITEK 2 Compact automatic microbial susceptibility analyzer,and statistical analysis was conducted by WHONET 5.6.Results A total of 169 strains of pathogens were isolated from the incision secretions and pus specimens of 292 patients with postoperative incision infection,of which the gram-positive cocci accounted for 59.2%,mainly including Staphylococcus aureus;the gram-negative bacilli accounted for 33.7%,mainly including Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Acinetobacter baumannii;the fungus accounted for 7.1%,mainly including Candida albicans. Susceptibility testing showed that Staphylococcus aureus was multi-resistant based on the oxacillin susceptibility testing,with the resistance rate of 48.3%;among gram-negative bacilli,Escherichia coli had slightly high resistance to β-lactam antibiotics,Klebsiella pneumoniae had high resistance to β-lactam antibiotics,Pseudomonas aeruginosa and Acinetobacter baumannii were sensitive to all types of antibiotics. Conclusion Staphylococcus aureus,Escherichia coli and Klebsiella pneumoniae are the main cause of postoperative incision infection and bacterial drug resistance is still severe,reasonable preoperative preparations and effective use of antibiotics are particularly important,which means that empirical medication should be reduced or avoided;at the same time,supervision of antibiotics use should be strengthened to prevent abuse and reduce the generation of drug-resistant strains.
作者
林海
王燕
LIN Hai;WANG Yan(Department of Pharmacy,Hainan Women and Children’s Medical Center,Haikou Hainan 571100,China;不详)
出处
《局解手术学杂志》
2021年第6期468-472,共5页
Journal of Regional Anatomy and Operative Surgery
基金
海南省卫生计生行业科研项目(20A200241)。
关键词
儿童医院
外科手术
手术部位感染
医院感染
致病菌
耐药性
Children’s hospital
surgical operation
surgical site infection
hospital infection
pathogenic bacteria
drug resistance
