72例剖腹产后感染的相关因素及病原菌分布特点

The factors related to the cesarean infection and the characteristics of pathogen distribution: a report with 72 cases

目的:探讨剖腹产后感染的相关因素及病原菌分布特点,为预防、治疗术后感染提供参考依据。方法:选取剖腹产术后感染的72例产妇作为研究对象,统计分析手术时间、住院时间、产程、是否伴有与感染相关的基础疾病、侵入性检查次数、胎膜早破、失血量及是否预防性应用抗菌药物等因素;采集切口分泌物进行细菌培养和鉴定。结果:logistic回归分析表明,当上述各因素达到一定阈值时均变成剖腹产术后感染的独立危险因素,差异均具有统计学意义(P<0.05);72份切口分泌物中共培养出128株病原菌,以大肠埃希菌、肠球菌属、铜绿假单胞菌为主,分别占38.8%、17.4%和11.6%。结论:切口感染以革兰阴性菌、尤其大肠埃希菌为主,临床治疗时应合理使用抗菌药物,及时控制感染。

Objective： To investigate the factors related to cesarean infection and the characteristics of pathogen distribution so as to provide a valuable reference for the prevention and treatment of postoperative infection. Methods： Seventytwo cases of parturients with postoperative infection were selected as subjects and the factors such as operation time, maternal hospitalization time, labor, underlying diseases associated with infection, the number of invasive examination, premature rupture of membranes, intraoperative blood loss and prophylactic use of antimicrobial drugs were statistically analyzed and incision secretions were collected and cultivated for the identification of bacteria. Results： Logistic regression analysis showed that the factors above-mentioned all became independent risk factors for postoperative infection when reached a certain threshold. The differences were statistically significant （P〈0.05）. One hundred and twenty pathogenic bacteria were found from the cultures of 72 incision secretions, in which Eseherichia coli, Enterocoeeus and Pseudomonas aeruginosa accounted for 38.8%, 17.4% and 11.6%, respectively. Conclusion： The majority of microbial infection is Gram negative bacteria, especially Escheriehia coli, which should be controlled by rational use of antimicrobial agents.