摘要
目的分析胃肠恶性肿瘤患者术后切口感染的病原菌及药敏分析。方法选择2003年6月-2011年6月医院收治的223例胃肠恶性肿瘤患者,其中男98例,女125例,年龄25～78岁,平均(44.5±5.2)岁,回顾性分析胃肠肿瘤患者术后切口感染的病原菌种类及药敏结果。结果 223例患者手术后病原学检测有45例出现切口感染,感染率为20.2%;共检出病原菌71株,其中革兰阳性菌20株,占28.2%,主要为粪肠球菌、金黄色葡萄球菌,分别占18.3%、9.9%,革兰阴性菌51株,占71.8%,主要为大肠埃希菌、铜绿假单胞菌、产气肠杆菌、阴沟肠杆菌、肺炎克雷伯菌,分别占23.9%、16.9%、15.5%、8.5%、7.0%;切口感染的病原菌中对常用的抗菌药物耐药性较高;革兰阳性菌对青霉素类、氨基糖苷类和喹喏酮类较敏感,敏感率最高的是万古霉素,为100.0%,革兰阴性菌对亚胺培南最为敏感,敏感率为100.0%。结论胃肠肿瘤患者术后切口感染主要致病菌为大肠埃希菌、粪肠球菌、铜绿假单胞菌、金黄色葡萄球菌,临床上切口感染较轻时,可选用氨基糖苷类或喹诺酮类,若切口感染呈中重度,则可选用头孢哌酮/舒巴坦、哌拉西林/他唑巴坦,严重感染时可选用亚胺培南。
OBJECTIVE To analyze the pathogens causing postoperative incision infections in patients with gastrointestinal cancer.METHODS A total of 223 patients with gastrointestinal cancer who enrolled in hospital from Jun 2003 to Jun 2011 were selected,including 98 males and 125 females,aged from 25 to 78 years with the mean age of（44.5±5.2） years.Retrospective analysis of the species of the pathogens causing postoperative incision infections in gastrointestinal cancer patients and the result of drug susceptibility was performed.RESULTS The incision infections occurred in 45 of 223 patients after the surgery with the infection rate of 20.2%;of 71 strains of pathogens isolated,there were 20（28.2%） strains of gram-positive bacteria including Enterococcus faecalis（18.3%） and Staphylococcus aureus（9.9%）;there were 51（71.8%） strains of gram-negative bacilli including Escherichia coli（23.9%）,Enterobacter cloacae（15.5%）,E.aerogenes（15.5%）,Klebsiella pneumoniae（7.0%）,and Pseudomonas aeruginosa（16.9%）;the drug resistance rates of the pathogens causing the incision infections to common antibiotics were relatively high;gram-positive bacteria were susceptible to penicillin,aminoglycoside and quinolones,the drug susceptibility rate to vancomycin was the highest（100.0%）;the drug susceptibility rate of gram-negative bacteria to imipenem was the highest（100.0%）.CONCLUSION The main pathogens causing incision infections in the patients with gastrointestinal cancer are E.coli,E.faecalis,P.aeruginosa,and S.aureus.We can choose the antibiotics such as the quinolone or the aminoglycoside for the slight infections,the antibiotics such as cefoperazone/sulbactam or piperacillin/tazobactam for moderate or severe infections,imipenem for critically severe infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第11期2322-2324,共3页
Chinese Journal of Nosocomiology
关键词
胃肠恶性肿瘤
切口感染
药敏反应
Malignant gastrointestinal cancer
Incision infection
Drug susceptibility testing
