剖宫产手术切口感染的菌群分布及药敏分析

Distribution and antimicrobial resistance of pathogenic bacteria causing surgical incision infections in cesarean section

目的探讨剖宫产手术切口感染病原菌的分布及耐药性,为临床预防控制切口感染提供参考依据。方法采集伤口分泌物进行细菌培养,分离病原菌,采用MicroScan WalkAway96微生物分析仪系统进行细菌鉴定与药敏分析,并对病原菌耐药率进行分析。结果从剖宫产手术切口感染部位分离到的52株病原菌中,主要为大肠埃希菌、金黄色葡萄球菌和粪肠球菌,分别占34.6%、13.5%和13.5%;大肠埃希菌除对亚胺培南和哌拉西林/他唑巴坦高敏外,对其他抗菌药物呈现不同程度的耐药,且显示了多药和交叉耐药性;产超广谱β-内酰胺酶(ESBLs)大肠埃希菌分离到10株,占55.6%;金黄色葡萄球菌除对青霉素类药物显示高耐药外,对其他抗菌药物较为敏感;青霉素类药物对粪肠球菌保持了较好的抗菌活性。结论必须采取切实的防治措施,预防与控制手术切口感染。

OBJECTIVE To explore the distribution and antimicrobial resistance of pathogenic bacteria causing surgical incision infections in cesarean section and provide reference for clinical prevention and control of incision infections.METHODS The secretions from infected wounds were cultured in order to identify pathogens,and MicroScan Walk Away96 microbial analyzer was employed to conduct automatic bacterial identification and the drug susceptibility testing,the resistance rate of bacteria was analyzed.RESULTS Totally 52strains of pathogenic bacteria causing incision infections were mainly Escherichia coli,Staphylococcus aureus and Enterococcus faecalis,accounting for 34.6%,13.5% and 13.5%,respectively.E.coli strains varied in the drug resistance except hypersensitivity to imipenem and piperacillin/tazobactam and showed multiple and cross drug resistance;there were 10（55.6%）strains of ESBLs-producing E.coliisolated;S.aureus strains showed high drug resistance to penicillin drugs and were highly sensitive to other antibiotics;the penicillin drugs maintained better antibacterial activity against the E.faecalis strains.CONCLUSIONPreventive measures should be taken to prevent and control the surgical incision infections.