普外科手术后病原菌及超广谱β内酰胺酶菌株感染原因分析

Analysis postoperative pathogen infection and reason for super broad spectrum β lactamase strain infection in general surgery

目的分析我院普外科手术后患者病原菌感染情况,重点回顾性研究超广谱β内酰胺酶菌株感染的原因,为临床提供基础依据。方法利用回顾性调查的研究方法对我院普外科550例住院患者手术后病原菌感染的情况进行调查统计。结果术后发生医院感染的患者43例,其中不合理用药23例,所有患者的抗生素使用率为100%,品种为39种,每位患者使用品种至少1种,最多8种,平均使用时间为20.2±13.5天。分析病原菌感染与手术复杂程度、切口在空气中暴露时间、插管表面接触、免疫力低下、手术损伤局部组织有关;另外检出的43例感染患者中有35株大肠埃希菌中产超广谱内酰胺酶(ESBLs)11株,10株克雷伯菌中产ESBLs 6株,占60.00%。结论普外科手术应当高度重视术中操作,防止术后切口ESBLs菌株感染,加强控制措施,降低手术切口感染发生率。

Objective To analyse postoperative pathogen infection in general surgery, to emphasize the retrospective study of super broad spectrum β lactamase strain infection reason. Methods Using retrospective survey research methods to survey the pathogen infection in 550 postoperative inpatients in general surgery. Results 43 patients had postoperative hospi- tal infection. Drug use was not rational in 23 patients. The antibiotic usage rate was 100% in all patients. There were 39 kinds of antibiotics. Each patient used at least one kind of antibiotics, 8 kinds at most. The average using time was （20.2±13.5） days. The cause of the pathogen infection were operation complex, incision exposured time, intraoperative intubation, hypoimmunity, the operation of local tissue damage. 35 strains of escherichia coli were detected in 43 patients with infection patients, 11 strains was extended spectrum β-1actamases（ESBLs）. There were 6 ESBLs strains in 10 klebsiella strains. Conclusion It should pay great attention to the general operation to prevent postoperative incision infection of ESBLs strains, strengthen the control mea- sures, reduce the surgical incision infection rate.