外科重症监护病房患者腹部术后腹腔感染的病原学特点分析

Etiology Characteristics of Intra-abdominal Infection afterAbdominal Surgery in Patients of Surgical Intensive Care Unit(SICU)

目的分析外科重症监护病房(SICU)的患者腹部手术后腹腔感染的病原学特点。方法回顾性地分析医院重症监护病房2005年6月-2008年6月收治的63例腹部术后腹腔感染患者的临床资料,了解其病原菌分布及耐药性。结果 63例患者共检出病原菌104株,其中革兰阴性杆菌76株(73.08%),革兰阳性球菌22株(21.15%),真菌6株(5.77%);主要病原菌依次为大肠埃希菌52株,肺炎克雷伯菌6株,金黄色葡萄球菌5株,粪肠球菌5株,奇异变形菌5株,铜绿假单胞菌4株,白色假丝酵母菌4株;耐甲氧西林金黄色葡萄球菌(MRSA)感染占金黄色葡萄球菌感染的40.00%,大肠埃希菌中产超广谱β-内酰胺酶者占36.54%。结论 SICU是感染最易发生的科室,腹部术后腹腔感染的病原菌及耐药性也在不断变化,临床医师应重视对病原菌的检测和药物敏感试验,合理使用抗菌药物,从经验性用药转为规范的目标性用药。

OBJECTIVE To analyze the etiology characteristics of intra-abdominal infection after abdominal surgery in patients of SICU.METHODS The postoperative clinical data of 63 cases with intra-abdominal infection,treated in our hospital SICU from Jun 2005 to Jun 2008 were retrospectively analyzed.The clinical characteristics and pathogen distribution and drug resistance were detected.RESULTS There were 104 pathogens detected,of which 76（73.08%） were Gram-negative bacilli,22（21.15%） Gram-positive cocci.The main pathogens by order were by Escherichia coli（52）,Klebsiella pneumoniae（6）,Staphylococcus aureus（5）,Enterococcus faecalis（5）,Proteus mirabilis（5）,Pseudomonas aeruginosa（4）,and Candida albicans（4）.The meticillin-resistant S.aureus infection accounted for 40.00% of S.aureus infections,extended-spectrum-lactamases producing E.coli accounted for 36.54%.CONCLUSION SICU is the department easier to occur infection,the pathogens and their drug resistance of intra-abdominal infection after surgery are also changing.Clinicians should take seriously pathogens examination and drug sensitivity test to reasonably and standardizedly（not empirically） use the antibiotics.