泌尿外科手术切口感染病原菌种类及感染相关因素调查

Investigation of pathogens and infection related factors of surgical incision infection in department of urology

目的探讨泌尿外科手术患者切口感染的病原菌种类和感染相关危险因素。方法回顾性收集该院泌尿外科2016年1月至2018年5月收治的400例手术患者的临床资料,根据术后是否发生切口感染分成感染组(n=65)和未感染组(n=335),整理感染组患者的病原菌种类,并对比两组的临床资料,调查感染的相关危险因素。结果共培养76株病原菌,其中甲氧西林敏感金黄色葡萄球菌占25.0%,耐甲氧西林敏感金黄色葡萄球菌占18.42%,大肠埃希菌占14.47%,铜绿假单胞菌和肺炎克雷伯菌均占11.84%,其余阴沟肠杆菌、肠球菌属、不动杆菌、变形杆菌占比较低。经危险因素分析:合并糖尿/心功能不全、手术时间长、住院时间长、抗菌药物使用种类多、留置导尿管均是影响术后切口感染发生的因素(P<0.05);多因素分析:住院时间长、手术时间长、术后留置导尿管是术后切口感染的独立危险因素(P<0.05)。结论泌尿外科手术患者术后切口感染的病原菌以甲氧西林敏感金黄色葡萄球菌、耐甲氧西林敏感金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主,切口感染发生的危险因素众多,医护人员应加强对高危人群的筛查,加强对高危人群的监控管理和护理管理,预防术后切口感染发生。

【Objective】To analyze pathogenic bacteria and related risk factors of incision infection in urological surgery patients.【Methods】The clinical data of 400 surgical patients admitted to the urology department of our hospital from January 2016 to May 2018 were retrospectively collected.According to whether incision infection occurred after surgery,they were divided into infection group(n=65)and non-infection group(n=335).The pathogenic bacteria in the infection group were sorted out,and the clinical data of the two groups were compared to investigate the related risk factors of infection.【Results】A total of 76 pathogenic bacteria were cultured,of which 25.0%were methicillin-sensitive staphylococcus aureus,18.42%were methicillinresistant staphylococcus aureus,14.47%were Escherichia coli,11.84%were Pseudomonas aeruginosa and Klebsiella pneumoniae,and the rest were Enterobacter cloacae,enterococcus,Acinetobacter and Proteus.Analysis of risk factors:age,diabetes/cardiac insufficiency,long operation time,long hospitalization time,many kinds of antibiotics and indwelling catheter were all factors that affect the occurrence of incision infection after operation(P<0.05).Multivariate analysis:long hospital stay,long operation time and indwelling catheter after operation were independent risk factors for incision infection after operation(P<0.05).【Conclusion】The pathogens causing incision infection in patients undergoing urological surgery are mainly methicillin-sensitive staphylococcus aureus,methicillin-resistant staphylococcus aureus,Escherichia coli,Klebsiella pneumoniae,and Pseudomonas aeruginosa.There are many risk factors for incision infection.Medical personnel should strengthen the screening of high-risk groups,strengthen the monitoring and nursing management of high-risk groups,and prevent the occurrence of incision infection after surgery.