电视胸腔镜辅助微创肺癌根治术后患者切口感染病原菌分布及耐药性分析

Distribution and drug resistance of pathogens in patients with incision infections after radical resection of lung cancer with video-assisted thoracoscopic assisted minimally invasive incision

目的分析电视胸腔镜辅助微创肺癌根治术后患者切口感染的临床特点并探究预防对策。方法选取医院2010年9月-2016年2月行电视胸腔镜辅助微创肺癌根治术患者1120例,分析患者术后切口感染率,并分析患者感染病原菌分布及耐药性。结果行电视胸腔镜辅助微创肺癌根治术患者术后感染76例,感染率为6.79%;76例感染患者共检出病原菌98株,病原菌主要为革兰阴性菌55株,占56.1%,革兰阳性菌43株,占43.9%;革兰阳性菌中金黄色葡萄球菌对青霉素耐药率最高为93.3%,对头孢他啶和万古霉素的耐药性为0,凝固酶阴性葡萄球菌对青霉素耐药率为100%。革兰阴性菌中大肠埃希菌及铜绿假单胞菌对左氧氟沙星耐药率最高分别为64.7%、100.0%。结论电视胸腔镜辅助微创肺癌根治术可降低患者术后切口感染率,但临床治疗中应重视术后切口感染病原菌的监测,依据切口感染病原菌的特点及耐药性,合理应用抗菌药物。

OBJECTIVE To investigate the clinical characteristics and prevention of incisional infections in patients undergoing thoracoscopic assisted minimally invasive incisional lung cancer after radical operation.METHODS A total of 1120 patients underwent thoracoscopic assisted minimally invasive incisional lung cancer after radical surgery from Jan.2010 to Feb.2016 were enrolled in this study.The postoperative infection rate of patients was analyzed,and the distribution of pathogenic bacteria and drug resistance were analyzed.RESULTS There were 76 cases of postoperative infections in patients with video-assisted thoracoscopic assisted minimally invasive incision of radical cancer,and the infection rate was 6.79%.There were 98 strains of pathogens detected in 76 patients with incisional infections,which were mainly 55 strains of gram-negative bacteria,accounting for 56.1%,and 43 strains of gram-positive bacteria,accounting for 43.9%.Among gram-positive bacteria,the resistant rate of Staphylococcus aureus to penicillin was the highest,which was 100%,and the resistant rates to ceftazidime and vancomycin were0%.The resistant rate of coagulase-negative Staphylococcus to penicillin was 100%.Among gram-negative bacteria,the resistant rates of Escherichia coli and Pseudomonas aeruginosa to levofloxacin were the highest,which were respectively 64.7% and 100.0%.CONCLUSION Video-assisted thoracoscopic assisted minimally invasive lung cancer radical surgery can reduce the incidence of postoperative incisional infections.However,it is necessary to pay attention to the monitoring of postoperative wound infection pathogens,and rational use of antibiotics is recommended,according to the characteristics and drug resistance of pathogenic bacteria in incision infections.