某院乳腺外科患者并发术后感染的病原菌分布与危险因素分析

Analysis of Pathogenic Bacteria Distribution and Risk Factors of Postoperative Infection in Patients of Breast Surgery in a Hospital

目的:分析医院乳腺外科患者并发术后感染的病原菌分布与危险因素,为该类患者术后感染的精准防治提供参考。方法:选取2019年1月—2021年12月崇义县人民医院收治的96例乳腺外科患者作为研究对象,按照是否发生术后感染分为感染组(n=21)和未感染组(n=75),采集患者的病原学检查结果,以及年龄、基础疾病、手术情况等资料,分析患者并发术后感染的病原菌分布与危险因素。结果:21例并发术后感染患者标本中共检出病原菌35株,其中革兰阴性菌17株(占48.75%,主要为肺炎克雷伯菌和大肠埃希菌)、革兰阳性菌15株(占42.86%,主要为金黄色葡萄球菌和表皮葡萄球菌)和真菌3株(占8.57%);回归分析结果显示,乳腺外科患者并发术后感染与年龄、合并糖尿病、营养情况、手术时长具有相关性(P<0.05),其中年龄>60岁、合并糖尿病、营养不良、手术时长>60 min是患者并发术后感染的独立危险因素(P<0.05)。结论:乳腺外科患者并发术后感染的致病菌主要有金黄色葡萄球菌、表皮葡萄球菌、肺炎克雷伯菌和大肠埃希菌,感染的发生与年龄、合并糖尿病、营养情况、手术时长密切相关,对于存在高危风险的患者临床应当加强管理,以减少感染的发生;对于发生感染的患者,临床应积极开展病原学检查和药敏试验,以提高治疗的准确性。

Objective:To investigate the distribution of pathogenic bacteria and risk factors of postoperative infection in patients of breast surgery in the hospital,so as to provide reference for the precise prevention and treatment of postoperative infection for such patients.Methods:A total of 96 patients of breast surgery admitted to Chongyi County People’s Hospital from January 2019 to December 2021 were selected as study subjects,and they were divided into infection group(n=21)and non-infection group(n=75)according to whether postoperative infection occurred.The data of patients such as etiological examination results,age,underlying diseases and surgical conditions were collected to analyze the distribution of pathogenic bacteria and risk factors of postoperative infections in the patients.Results:A total of 35 strains of pathogenic bacteria were detected in the specimens of 21 patients with postoperative infection,including 17 strains of Gram-negative bacteria(48.75%,mainly Klebsiella pneumoniae and Escherichia coli),15 strains of Gram-positive bacteria(42.86%,mainly Staphylococcus aureus and Staphylococcus epidermidis)and 3 strains of fungi(8.57%);the regression analysis results showed that postoperative infection in patients of breast surgery was related to age,diabetes mellitus,nutritional status and duration of surgery(P<0.05),of which,the age greater than 60years old,diabetes mellitus,poor nutrition and duration of surgery longer than 60 min were independent risk factors of postoperative infection(P<0.05).Conclusion:The pathogenic bacteria associated with postoperative infection in patients of breast surgery mainly include Staphylococcus aureus,Staphylococcus epidermidis,Klebsiella pneumoniae and Escherichia coli.The occurrence of infection is closely related to the age,diabetes mellitus,nutritional status and duration of surgery.Clinical management should be strengthened for patients with high risk to reduce the occurrence of infection;the etiological examination and drug susceptibility test should be actively carried out clinically to improve the accuracy of treatment.