胃切除患者术后感染病原菌与耐药性分析

Analysis of the drug resistance and risk factors of pathogen infection patients after gastrectomy

目的研究行胃切除术后感染患者的病原菌及感染危险因素,控制胃切除术后感染的发生。方法调查2011年1月-2012年8月208例行胃切除患者临床资料,留取感染患者的标本进行分离培养,采用K-B琼脂法对分离出的病原菌进行耐药性分析,并分析发生感染的相关因素,采用SPSS17.0软件进行统计分析。结果 208例行胃切除的患者发生感染112例,感染率53.85%;分离出124株病原菌,其中革兰阳性菌48株占38.71%,革兰阴性菌76株占61.29%;主要革兰阳性菌对青霉素耐药率较高,>85.00%;对利奈唑胺及替考拉宁耐药率较低,<12.00%;主要革兰阴性菌对亚胺培南及阿米卡星耐药率较低,<6.00%;行胃切除的患者发生感染与其年龄、住院时间、留置尿管及使用呼吸机等因素有关。结论医疗过程中应严格执行各项规章制度预防感染,如若胃切除术后感染发生,首先应分离培养病原菌,并进行耐药性分析,选择耐药率低的抗菌药物进行及时的治疗。

OBJECTIVE To study risk factors and the distribution of pathogenic bacteria of infected patients after gastrectomy so as to better control the occurrence of infections after gastrectomy.METHODS Totally 208 cases of infected patients were chosen from Jan.2011 to Aug.2012,and pathogenic bacteria were isolated and cultured,the drug sensitivity tests were conducted to the isolated pathogenic strains by K-B method（agar diffusion）.Then related risk factors were analyzed by SPSS 17.0software.RESULTS A total of 112 cases of patients were infected in the 208cases;the infection rate was 53.85%.Totally 124 strains of pathogenic bacteria were isolated,and 48 strains were gram-positive bacteria,accounting for 38.71%,and 76 strains were gram-negative bacteria,accounting for 61.29%.Gram-positive bacteria had a high resistance to penicilin（〉85.00%）while a low resistance to teicoplanin and linezolid（〈12.00%）.Gram-negative bacteria had a low resistance to amikacin and imipenem（〈6.00%）.The risk factors of gastrectomy infection contained patient＇s age,duration of hospitalization,the inserted catheter and the use of respirator.CONCLUSIONRegulation and rules during medication should be strictly obeyed to prevent infections.When infections occurred after gastrectomy,pathogenic bacteria types should be distinguished and drug resistance test should be conducted.Antibiotics which show low drug resistance should be chosen in time for treatment.