消化道肿瘤患者术后感染病原菌分布与危险因素分析

Distribution of pathogens causing postoperative infections in gastrointestinal cancer patients and analysis of risk factors

目的探讨消化道肿瘤患者术后感染病原菌分布及相关危险因素,为降低患者术后感染率提供依据。方法回顾性分析2010年1月-2014年12月医院1 000例消化道肿瘤患者临床资料,分析其感染部位、病原菌及相关危险因素,采用SPSS 19.0统计软件进行分析;采用法国生物梅里埃公司的ATB半自动细菌鉴定仪进行菌株鉴定。结果 1 000例消化道肿瘤患者术后感染152例,感染率为15.20%,感染部位主要为上呼吸道、下呼吸道、食管、直肠,分别占30.26%、21.71%、17.76%、13.16%;共检出病原菌150株,其中革兰阴性菌105株占70.00%,革兰阳性菌43株占28.67%,真菌2株占1.33%,革兰阴性菌主要为大肠埃希菌、铜绿假单胞菌,分别占24.67%、17.33%;革兰阳性菌主要为金黄色葡萄球菌、粪肠球菌,分别占12.67%、10.00%;年龄、体质量指数、手术时间、切口等级、侵入性操作、合并糖尿病是消化道肿瘤患者术后发生医院感染的危险因素(P<0.05)。结论消化道肿瘤患者术后感染相关危险因素较多,应采取对应措施,以降低消化道肿瘤患者术后感染发生率。

OBJECTIVE To explore the distribution of pathogens causing postoperative infections in patients with gastrointestinal cancer and analyze the related risk factors so as to reduce the incidence of postoperative infections.METHODS The clinical data of 1 000 patients with gastrointestinal cancer who were treated in the hospital from Jan 2010 to Dec 2014 were retrospectively analyzed,then the infection sites,distribution of pathogens,and related risk factors were observed,the statistical analysis was performed with the use of SPSS 19.0software,and the strains were identified by using ATB semi-automatic bacterial identification system of BioMérieux,France.RESULTS The postoperative infections occurred in 152 of 1 000 gastrointestinal cancer patients with the infection rate of 15.20%,of whom 30.26% had the upper respiratory tract infections,21.71% had the lower respiratory tract infections,17.76% had the esophageal infections,and 13.16% had the rectal infections.A total of 150 strains of pathogens have been isolated,including 105（70.00%）strains of gram-negative bacteria,43（28.67%）strains of gram-positive bacteria,and 2（1.33%）strains of fungi.Escherichia coli and Pseudomonas aeruginosa were the major species of gram-negative bacteria,accounting for 24.67% and 17.33%,respectively;the Staphylococcus aureus and Enterococcus faecalis were dominant among the gram-positive bacteria,accounting for 12.67%and 10.00%,respectively.The risk factors for the postoperative nosocomial infections in the gastrointestinal cancer patients included the age,body mass index,operation duration,types of incision,invasive operation,and complication of diabetic mellitus（P〈0.05）.CONCLUSIONThere are a variety of risk factors for the postoperative infections in the gastrointestinal cancer patients.It is necessary to take targeted measures so as to reduce the incidence of postoperative infections in the gastrointestinal cancer patients.