宫腔镜术后患者发生盆腔感染的病原学特点及高危因素分析

Etiological characteristics and risk factor analysis of pelvic infection in patients after hysteroscopic surgery

目的探讨宫腔镜术后患者发生盆腔感染的病原学特点及高危因素。方法回顾性分析2016年1月-2018年12月在本院接受宫腔镜术诊治的586例患者的临床资料。根据患者有无发生盆腔感染,分为感染组42例和未感染组544例,采用Logistic回归分析确定患者术后发生盆腔感染的高危因素,并分析病原学特点及耐药情况。结果 586例宫腔镜术后患者盆腔感染发生率为7.16%(42/586);共培养出71株病原菌,其中革兰阴性菌占67.6%,前3位主要感染的细菌为大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌;3种主要革兰阴性菌对阿米卡星、亚胺培南、美罗培南均较敏感;粒细胞缺乏症、慢性阴道炎、恶性肿瘤及糖尿病史是患者宫腔镜术后盆腔感染的独立危险因素(P <0.05)。结论宫腔镜术后患者发生盆腔感染危险因素较多,其主要病原菌为革兰阴性菌且耐药率较高,临床应针对高危因素采取有效措施,降低感染发生率。

Objective To investigate the etiological characteristics and risk factors of pelvic infection in patients after hysteroscopic surgery.Methods The clinical data of 586 patients who underwent hysteroscopic surgery in our hospital from January to February 2018 were retrospectively analyzed.According to the patients with pelvic infection,42 cases were infected and 544 cases were not infected.Logistic regression analysis was used to determine the risk factors of postoperative pelvic infection,and the pathogenic characteristics and drug resistance were analyzed.Results The incidence of pelvic infection in 586 patients underwent hysteroscopic surgery was 7.16%(42/586).71 strains of pathogens were cultured,of which 67.6%were Gram-negative bacteria.The first three major infections were:Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa;three major Gram-negative bacteria are sensitive to amikacin,imipenem,and meropenem;agranulocytosis,chronic vaginitis,malignant tumors and the history of diabetes were independent risk factors for pelvic infection after hysteroscopic surgery(P<0.05).Conclusion There are many risk factors for pelvic infection in patients undergoing hysteroscopic surgery.The main pathogens are Gram-negative bacteria and the drug resistance rate is high.The clinical measures should be taken to reduce the incidence of infection.