妇科术后盆腔感染患者致病菌培养及药敏试验结果分析

Pathogenic Bacteria Culture and Drug Sensitivity Test in Patients with Pelvic Infection After Gynecological Surgery

目的分析妇科术后盆腔感染患者致病菌培养及药敏试验结果。方法选取2018年2月至2020年2月于商丘市第一人民医院接受妇科手术后发生盆腔感染的68例患者为研究对象。采用全自动细菌检定仪检测患者致病菌,并采用纸片扩散(K-B)法检测致病菌对抗菌药物的耐药情况。分析妇科术后盆腔感染患者常见致病菌及药敏试验结果。结果68例妇科术后盆腔感染患者共分离75株致病菌:革兰阴性菌52株,以大肠埃希菌、肺炎克雷伯菌为主;革兰阳性菌20株,以表皮葡萄球菌、粪肠球菌为主;真菌3株。大肠埃希菌对头孢唑林钠、左氧氟沙星、阿莫西林克拉维酸钾、氨苄西林、庆大霉素的耐药率较高,对亚胺培南、美罗培南的敏感性较高;肺炎克雷伯菌对头孢曲松钠、头孢唑林钠、阿莫西林克拉维酸钾、氨苄西林、庆大霉素、环丙沙星的耐药率较高,对亚胺培南、美罗培南、头孢哌酮钠舒巴坦钠、阿米卡星的敏感性较高;表皮葡萄球菌对氨苄西林、苯唑西林、青霉素G、头孢曲松、环丙沙星、庆大霉素的耐药率较高,对呋喃妥因、利福平、替考拉宁、万古霉素、利奈唑胺的敏感性较高;粪肠球菌对氨苄西林、苯唑西林、青霉素G、环丙沙星、庆大霉素的耐药率较高,对替考拉宁、万古霉素、利奈唑胺的敏感性较高。结论大肠埃希菌、表皮葡萄球菌是引发妇科术后盆腔感染的主要致病菌,且对多种抗菌药物耐药。应积极进行病原学检查及药敏试验,为临床合理使用抗生素提供重要的参考依据。

Objective To analyze the results of pathogenic bacteria culture and drug sensitivity test in patients with pelvic infection after gynecological operation.Methods A total of 68 patients with pelvic infection after gynecological surgery in Shangqiu First People’s Hospital from February 2018 to February 2020 were selected as the research subjects.The full-automatic bacterial tester was used to detect the pathogenic bacteria of patients.The drug resistance of pathogenic bacteria to antibiotics was detected by disk diffusion(K-B).The common pathogenic bacteria and drug sensitivity test results of patients with pelvic infection after gynecological surgery were analyzed.Results A total of 75 strains of pathogenic bacteria were isolated from 68 patients with pelvic infection after gynecological surgery,including 52 strains of Gram-negative bacteria,mainly Escherichia coli and Klebsiella pneumoniae.There were 20 strains of Gram-positive bacteria,mainly Staphylococcus epidermidis and Enterococcus faecalis.There were 3 strains of fungi.Escherichia coli had high resistance to cefazolin sodium,levofloxacin,amoxicillin potassium clavulanate,ampicillin and gentamicin,and high sensitivity to imipenem and meropenem.Klebsiella pneumoniae had high resistance to ceftriaxone sodium,cefazolin sodium,amoxicillin potassium clavulanate,ampicillin,gentamicin and ciprofloxacin,and high sensitivity to imipenem,meropenem,cefoperazone sodium sulbactam sodium and amikacin.Staphylococcus epidermidis had high resistance to ampicillin,oxacillin,penicillin G,ceftriaxone,ciprofloxacin and gentamicin,and high sensitivity to furantoin,rifampicin,teicoplanin,vancomycin and linezolid.Enterococcus faecalis had high resistance to ampicillin,oxacillin,penicillin G,ciprofloxacin and gentamicin,and high sensitivity to teicoplanin,vancomycin and linezolid.Conclusion Escherichia coli and Staphylococcus epidermidis are the main pathogens in patients with pelvic infection after gynecological surgery,and they are resistant to a variety of antibiotics.Etiological examination and drug sensitivity test should be carried out actively to provide important reference for rational use of antibiotics in clinic.