妇产科手术部位感染病原菌及耐药性研究

Study on pathogens causing surgical site infections in obstetrics and gynecology department and the drug resistance

目的研究妇产科手术部位感染病原菌及耐药性特征,为合理使用抗菌药物提供依据。方法调查2008年1月-2011年12月医院妇产科手术部位感染分离的149株病原菌分布及耐药性。结果病原菌分布中革兰阳性球菌占44.97%,革兰阴性杆菌占55.03%;前3位的病原菌为大肠埃希菌占44.29%、肠球菌属占18.12%、金黄色葡萄球菌占8.72%;大肠埃希菌中产ESBLs菌检出率为54.55%;凝固酶阴性葡萄球菌中MRCNS检出率为64.71%;产ESBLs大肠埃希菌对亚胺培南、美罗培南、哌拉西林/他唑巴坦100.00%敏感,对阿米卡星耐药率较低(<10.00%);肠球菌属对利奈唑胺、替考拉宁、阿莫西林/克拉维酸、万古霉素高度敏感,对头孢西丁、氨基糖苷类的阿米卡星、庆大霉素、妥布霉素耐药率<30.00%。结论研究妇产科手术部位感染病原菌及耐药性特征,加强病原菌多药耐药菌监测,为临床合理使用抗菌药物提供重要依据。

OBJECTIVE To study the pathogenic bacteria causing surgical site infections in the obstetrics and gynecology department so as to guide the reasonable use of antibiotics. METHODS A total of 149 strains of pathogenic bacteria causing the surgical site infections were isolated from obstetrics and gynecology department from Jan 2008 to Dec 2011, and the characteristics of the pathogenic bacteria and drug resistance were analyzed. RESULTS Of the pathogens isolated, the gram-positive bacteria accounted for 44. 97%, and the gram-negative bacilli accounted for 55.03% ; the Escherichia coli, Enterococcus, and Staphylococcus aureus were the top three species of pathogens, accounting for 44. 29%, 18. 12% , and 8. 72% , respectively. The detection rate of the ESBLs-producing E. coli was 54.55 % ; the detection rate of the methicillin-resistant coagulase-negative Staphylo- cocci（MRCNS） was 64. 71%. The drug susceptibility rates of the ESBLs-producing E. coli to imipenem, meropenem, and piperacillin/tazobactam were 100.00%, and the drug resistance rate to amikacin was less than 10.00%; the Enterococcus strains were highly susceptible to linezolid, teicoplanin, vancomycin, and amoxicillin/ clavulanic acid, and the drug resistance rates to cefoxitin, amikacin, gentamicin, and tobramycin were less than 30.00%. CONCLUSION It is necessary to study on the characteristics of distribution and drug resistance of the pathogens causing the surgical site infections in the obstetrics and gynecology department and to strengthen the monitoring of multidrug-resistant pathogens so as to provide basis for the reasonable clinical use of antibiotics.