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目的:分析妇科腹腔镜手术后切口感染致病菌的分布及其耐药性。方法:选取2014年10月—2015年10月间收治的行妇科腹腔镜手术的患者384例的病历资料,分析其中出现切口感染患者致病菌感染情况及其耐药性。结果:药敏试验结果显示,切口感染例数41例致病菌50株,所占百分率为10.68%;感染的病原菌中主要是以铜绿假单胞杆菌、大肠埃希菌、克雷伯杆菌为代表的革兰阴性杆菌占68.00%,革兰阳性菌也有一定比例占22.00%,还有少量真菌感染占10.00%;大多数病原菌对氨卡西林、复方磺胺甲噁唑耐药,对庆大霉素、左氧氟沙星、亚胺培南等药物在治疗革兰阴性杆菌有较好的治疗效果,其中以亚胺培南耐药性为最低;万古霉素对革兰阳性杆菌治疗效果为最佳。结论:妇科腹腔镜手术治疗的患者,手术切口感染的发生主要是革兰阴性杆菌引起的,抗菌治疗中以对革兰阴性菌敏感的亚胺培南治疗效果为最佳。
Objective: To analyze the distribution and drug resistance of pathogenic bacteria in incision infection after gynecological laparoscopic surgery. Methods: 384 cases of gynecological laparoscopic surgery admitted to our hospital from October 2014 to October 2015 were selected and their medical records were analyzed. The pathogen infection and drug resistance were analyzed in patients with incision infection. Results: The susceptibility test results showed that there were 50 cases of pathogenic infection in 41 cases, accounting for 10.68%. The main pathogen of infection was Pseudomonas aeruginosa, Escherichia coli and Klebsiella Gram-negative bacilli accounted for 68.00%, Gram-positive bacteria also accounted for a certain proportion of 22.00%, there are a small amount of fungal infection accounted for 10.00%; most of the pathogenic bacteria on amikacin, sulfamethoxazole resistance, Levofloxacin, imipenem and other drugs in the treatment of Gram-negative bacilli have a better therapeutic effect, of which imipenem resistance was the lowest; vancomycin on Gram-positive bacilli treatment for the best. Conclusions: In patients undergoing gynecological laparoscopic surgery, the incidence of surgical incision infection is mainly caused by Gram-negative bacilli. The best antibiotic treatment is imipenem, which is sensitive to Gram-negative bacteria.