妇产科患者手术后感染病原菌与耐药性分析

Species and drug resistance of pathogens causing infections after obstetric operation

目的调查了解医院妇产科患者手术后医院获得性感染病原菌分布及耐药性,为临床医师确诊疾病与选择敏感药物抗感染提供参考依据。方法选取2014年1-12月入住妇产科6 834例手术患者的临床资料,分析医院感染患者的病原菌分布及耐药性,数据采用WHONET 5.6软件进行统计分析。结果 6 834例患者发生感染275例,感染率为4.0%;共分离得到306株病原菌,以革兰阴性菌为主,共189株占61.8%;革兰阴性菌耐药率对磺胺甲噁唑/甲氧苄啶耐药率最高,耐药率为60.3%～74.2%,耐药率〉40.0%的药物为头孢类和喹诺酮类抗菌药物。结论妇产科手术后医院感染病原菌的耐药现状已非常严重,医疗机构应将抗菌药物使用管理列为重中之重,提高医师抗菌药物处方水平,控制医院流行菌的耐药性。

OBJECTIVE To understand species distribution and drug resistance of pathogens causing nosocomial infections after obstetric operation,and to provide experimental evidence for clinical diagnosis and use of antibiotics.METHODS Clinical records of 6834 patients in department of obstetrics and gynecology were reviewed retrospectively from Jan.to Dec.2014.Distribution and drug resistance of pathogens that infected patients were analyzed.Data were analyzed statistically with WHONET 5.6.RESULTS Among 6834 patients underwent obstetric operation,275（4.0%）of them suffered from nosocomial infections.Among 306 isolated,gram-negative bacteria predominate,accounting for 61.8%.The antibiotics with the highest resistance rate against gram-negative bacteria were sulfamethoxazole/trimethoprim（60.3%～74.2%）.The antibiotics with resistance rate higher than 40%included cephalosporins and quinolones.CONCLUSION Drug resistance of pathogens causing nosocomial infections after obstetric operation has been very severe.Management of antibiotics should be a top priority in medical institutions.In order to do so,doctors ability to prescribe antibiotics should be improved,and drug resistance of epidemic pathogens should be controlled.