妇科患者术后呼吸道感染病原菌分布及药敏分析

Distribution of pathogenic bacteria and drug sensitivity of respiratory tract infection among gynecological patients

目的分析妇科术后呼吸道感染病原菌耐药性及干预对策,为感染的临床防治及抗菌药物使用提供临床指导。方法分析2009年3月-2012年3月收治的1 352例妇科手术患者临床资料,分析呼吸道感染患者病原菌分布及药敏检测结果,探讨干预对策,将确诊呼吸道感染患者按照随机数字表分为常规干预组及加强干预组,数据采用SPSS 13.0进行分析。结果 1 352例患者共出现94例医院感染,感染率6.95%;共检出病原菌123株,其中革兰阴性菌96株占78.05%,革兰阳性菌18株占14.63%,真菌9株占7.32%;鲍氏不动杆菌对左氧氟沙星耐药性较低,耐药率为19.05%。结论妇科术后呼吸道感染病原菌以革兰阴性菌为主,对左氧氟沙星耐药性较低,对亚胺培南、美罗培南及第三代头孢菌素耐药性较高,加强干预措施可有效改善患者感染率,促进患者的康复。

OBJECTIVE To analyze the drug resistance of pathogens and intervention measures of respiratory tract infections after gynecological surgery, so as to provide clinical guidance for clinical treatment and antibiotic medica- tion use. METHODS Based on the analysis of clinical data from 1 352 cases which received gynecologic operation from Mar 2009 to Mar 2012, the distribution of pathogenic bacteria and drug sensitivity test results were fully analyzed, intervention measures were explored, and the SPSS13.0 software was utilized to analyze the routine control group and the intensified control group which were divided in accordance with random number table among confirmed cases with respiratory tract infection. RESULTS Among the 1 352 patients, 94 cases were infected in the hospital, with an infection rate of 6.95%. Totally 123 pathogenic strains were detected, including 96 strains of gram negative bacteria, accounting for 78.05%, 18 strains of gram positive bacteria, accounting for 14.63%, and 9 strains of fungi, accounting for 7.32%. Acinetobacter baumannii presented a low drug resistance rate to levo- floxacin, only 19.05 %. CONCLUSION The gram negative bacteria is the main pathogens of respiratory tract infec- tions after gynecological operation, which bears low drug resistance to levofloxacin, but high drug resistance to imipenem, meropenem and thir＆generation cephalosporins. Diet nursing, psychological nursing and other intensi- fied intervention measures can effectively reduce the infection rate among patients and improve their health conditions.