妇科开腹手术后感染的病原菌分布及药敏试验分析

Distribution and drug sensitivity of pathogenic bacteria in postoperative infection of gynecological laparotomy

目的探讨妇科开腹手术后感染的病原菌分布及其耐药性,为临床治疗术后感染提供参考。方法回顾性分析2010年2月-2012年12月950例妇科开腹手术患者临床资料,对发生术后感染患者的病原菌分布及耐药性进行分析。结果术后感染患者34例,发生率为3.58%,病原菌的标本来源构成以尿液为主,占60.98%。共分离病原菌41株,其中革兰氏阴性菌28株(68.29%)、革兰氏阳性菌11株(26.83%)、真菌2株(4.87%)。革兰氏阴性菌主要为大肠埃希菌、铜绿假单胞菌,对亚胺培南、头孢吡肟敏感;革兰氏阳性菌主要为金黄色葡萄球菌、凝固酶阴性葡萄球菌,对万古霉素、利奈唑胺均敏感;上述病原菌均对苯唑青霉素、左氧氟沙星有较高耐药率。结论妇科开腹手术后感染的病原菌分布广泛,临床应重视病原菌监测,根据药敏试验结果指导临床合理用药。

Objective To explore the distribution and drug sensitivity of pathogenic bacteria causing infection after gynecologi- cal laparotomy, and to provide reference for clinical treatment of postoperative infection. Methods The clinical data of 950 pa- tients who had undergone gynecological laparotomy were retrospectively analyzed from February 2010 to December 2012. The distribution and drug sensitivity of pathogenic bacteria were analyzed in these patients with postoperative infection. Results There were 34 patients with postoperative infection, the incidence rate was 3.58%. Urine was the main specimens source, ac- counting for 60.98%. A total of 41 strains of pathogens were isolated, including 28 strains of gram - negative bacteria （68.29%）, 11 strains of gram - positive bacteria （26.83 % ）, and 2 strains of fungi （4.87 % ）. Gram - negative bacteria were mainly Escherichia coli and Pseudomonas aeruginosa, sensitive to imipenem and cefepime ; Gram - positive bacteria were mainly Staphylococcus aureus and coagulase - negative staphylococci, sensitive to vancomycin and linezolid; the above - mentioned pathogens were highly resistant to oxacillin and levofloxacin. Conclusion The pathogenic bacteria causing infection after gyne- cological laparotomy were widespread, so it is necessary to strengthen pathogen monitoring and select appropriate drugs for clini- cal treatment according to drug sensitivity test results.