手术切口感染的病原菌分布与耐药性分析

Pathogenic bacteria distribution and drug resistance analysis of surgical incision infections

目的调查手术切口感染病原菌的分布和耐药性,为临床细菌性感染的诊断与治疗提供参考依据。方法回顾性分析2003年1月-2013年1月发生手术切口感染的638例患者细菌培养和药敏检查的结果,按照《全国临床检验操作规程》培养分离鉴定菌种,K-B纸片扩散法进行药物敏感试验,分析其病原菌的分布和耐药率;采用SPSS 17.0进行数据统计分析。结果手术切口感染病原菌中前3位的为大肠埃希菌102株占15.99%、金黄色葡萄球菌89株占13.95%、肺炎克雷伯菌83株占13.01%;大肠埃希菌对左氧氟沙星耐药率最高为62.75%、对亚胺培南的耐药率最低为0;铜绿假单胞菌对左氧氟沙星、头孢哌酮的耐药率均达到100.00%,而对莫西沙星、头孢地嗪、头孢匹罗以及亚胺培南的耐药率均为0;肺炎克雷伯菌对左氧氟沙星的耐药率较高,为56.63%,而对头孢匹罗、头孢哌酮及亚胺培南的耐药率均为0;金黄色葡萄球菌对青霉素的耐药率高达91.01%,而对头孢他啶以及万古霉素的耐药率均为0;粪肠球菌对环丙沙星的耐药率最高为64.06%、而对克林霉素以及万古霉素的耐药率均为0;凝固酶阴性葡萄球菌对青霉素耐药率高达100.00%、而对头孢他啶以及万古霉素的耐药率均为0。结论临床应重视手术切口感染病原菌的监测,根据病原菌分布和耐药率的变化特点调整治疗方案,选择适合的抗菌药物,减少手术切口感染的发生率和耐药菌的产生。

OBJECTIVE To investigate the pathogenic bacteria distribution and drug resistance of surgical incision infection,and provide reference for prevention measures in clinical.METHODS The bacterial culture and drug sensitive test results of 638patients with surgical incision infections of our hospital from Jan.2003to Jan.2013were analyzed retrospectively.Isolation and identification according to the national clinical laboratory operating procedures,and the drug sensitivity test was performed by K-B disk diffusion method to analyze the pathogenic bacteria distribution and drug resistance.SPSS17.0software was used for statistical analysis.RESULTS The most common pathogenic bacteria of surgical incision infections were Escherichia coli,which was 102strains accounted for15.99%.Followed by Staphylococcus aureus 89strains accounted for 13.95% and Klebsiella pneumoniae 83strains accounted for 13.01%.E.coli to levofloxacin resistance rate was the highest 62.75%and the lowest was to imipenem 0.Pseudomonas aeruginosa resistant to levofloxacin,cefoperazone sodium rates reached 100.00%,but to moxifloxacin,cefodizime,cefpirome and imipenem resistance rates were 0.K.pneumoniae resistant to levofloxacin rate was high 56.63%,while the cefpirome,cefoperazone sodium and imipenem resistance rates were0.Staphylococcus aureus resistant to penicillin was as high as 91.01%,while the ceftazidime sodium and vancomycin resistance rates were 0.Enterococcus faecalis resistance to ciprofloxacin was the highest 64.06%,of clindamycin and vancomycin resistance rates were 0.coagulase negative S.aureus resistant to penicillin rate reached100.00%,and to ceftazidime sodium and vancomycin resistance rates were 0.CONCLUSION More attention should be paid to surgical incision infections.The treatment plan should be adjusted according to the pathogenic bacteria distribution and drug resistance rate in clinical.The antibiotics should be used properly to reduce the rate of surgical incision infections and bacterial resistance.