急性阑尾炎患儿术后切口感染病原菌分布与耐药性分析

Pathogen distribution and drug resistance analysis to acute appendicitis incision infections in children

目的探讨急性阑尾炎患儿术后切口感染病原菌分布及耐药性,为临床有效治疗阑尾炎术后切口感染提供理论依据。方法选取医院2012年10月-2015年10月收治597例急性阑尾炎患儿为研究对象,统计分析其术后切口感染率、感染病原菌分布及药敏试验结果,数据采用SPSS 19.0软件进行统计处理。结果 597例急性阑尾炎患儿术后切口感染52例,感染率为8.71%;共培养出病原菌68株,其中革兰阴性菌42株占67.76%,革兰阳性菌26株占38.24%;大肠埃希菌对阿莫西林的耐药率最高为56.25%,肺炎克雷伯菌对庆大霉素的耐药率最高为100.00%,铜绿假单孢菌对头孢他定的耐药率最高为91.67%;金黄色葡萄球菌对头孢曲松的耐药率最高为55.56%,粪肠球菌对克林霉素和四环素的耐药率较高均为80.00%;凝固酶阴性葡萄球菌对克林霉素、四环素的耐药率均为80.00%。结论导致急性阑尾炎患儿术后切口感染的病原菌主要为革兰阴性菌,其次为革兰阳性菌,其对常用抗菌药物的耐药性较高,因此,加强抗菌药物监管、防止抗菌药物滥用,针对性地合理选择抗菌药物治疗,可以提高患者治疗效果和生活质量,值得引起临床重视。

OBJECTIVE To investigate the pathogen distribution and drug resistance of postoperative acute appendicitis incision infections in children,so as to provide a theoretical basis for an effective treatment to clinical appendicitis incision infection.METHODS A total of 597 cases of acute appendicitis in children from Oct.2012 to Oct.2015 admitted to our hospital were selected as research subjects.The infection rate of postoperative wound infection,pathogen distribution and antimicrobial susceptibility test were analyzed.SPSS 19.0was used for data analysis.RESULTS There were 52 cases from 597 cases had postoperative infection in children with acute appendicitis,and the infection rate was 8.71%.A total of 68 strains of pathogens were cultured,and 42 strains of gram-negative bacteria,accounting for 67.76%,26 strains of gram-positive bacteria,accounting for 38.24%.Antimicrobial resistance rates of E.coli up to amoxicillin was 56.25%;Klebsiella pneumoniae resistance rates to gentamicin was the highest 100.00%;Pseudomonas aeruginosa resistant rate to ceftazidime was the highest 91.67%.Antimicrobial resistance rates of Staphylococcus aureus to ceftriaxone was the highest 55.56%;the resistance rates of Enterococcus faecalis,to clindamycin and tetracycline were all in high level 80.00%.The resistant rates of coagulase-negative Staphylococci to clindamycin and tetracycline were 80.00%.CONCLUSION The cause of acute appendicitis in children with postoperative infection mainly is gram-negative bacteria,gram-positive bacteria followed,which have a high drug resistance to commonly used antimicrobials.Therefore,antibiotics supervision strengthen,preventing overuse of antibiotics,rational choice of targeted antibiotic therapy,can improve the therapeutic effect and quality of life of patients,which should be paid attention in clinic.