药物流产患者清宫术后感染病原菌与耐药性调查分析

Distribution and drug resistance of pathogens causing postoperative infections in drug abortion patients undergoing curettage

  • 摘要: 目的 探讨药物流产患者行清宫术后感染病原菌及耐药性,为临床预防和治疗清宫术后感染提供参考。方法 选取医院2011年1月-2015年6月药物流产行清宫术后感染120例患者作为研究对象,分析患者感染病原菌种类,并进行病原菌耐药性分析。结果 120例患者共检出178株病原菌,其中革兰阳性菌38株占21.35%,革兰阴性菌140株占78.65%,革兰阳性菌中以金黄色葡萄球菌和粪肠球菌最多,革兰阴性菌中以大肠埃希菌、弗氏志贺菌及沙门菌属最多;大肠埃希菌、弗氏志贺菌、沙门菌属、肺炎克雷伯菌和铜绿假单胞菌对美罗培南和亚胺培南敏感率为100.00%;对氨曲南、头孢吡肟和头孢西丁的敏感率也较高,达80.00%以上;粪肠球菌和金黄色葡萄球菌对青霉素、苯唑西林、红霉素、庆大霉素和左氧氟沙星耐药率较高,普遍>40.00%。结论 清宫术后感染相关病原菌耐药性严重,临床早期经验用药时需要借鉴,避免选择耐药严重的药物。

     

    Abstract: OBJECTIVE To explore the distribution and drug resistance of pathogens causing postoperative infections in drug abortion patients undergoing curettage so as to provide guidance for clinical prevention and treatment of the postoperative infections in the patients undergoing curettage. METHODS A total of 120 drug abortion patients who underwent the curettage in the hospital from Jan 2011 to Jun 2015 and were complicated with postoperative infections were recruited as the study objects, then the distribution of the pathogens causing the infections were observed, and the drug resistance of the pathogens was analyzed. RESULTS Totally 178 strains of pathogens were isolated from the 120 patients, including 38 (21.35%) strains of gram-positive bacteria and 140 (78.65%) strains of gram-negative bacteria; the Staphylococcus aureus and Enterococcus faecalis were dominant among the gram-positive bacteria; the Escherichia coli, Shigella flexneri, and Salmonella spp dominated among the gram-negative bacteria. The drug susceptibility rates of the E.coli, S.flexneri, Salmonella spp, Klebsiella pneumoniae, and Pseudomonas aeruginosa to meropenem and imipenem were 100.00%; the drug susceptibility rates to aztreonam, cefepime, and cefoxitin were more than 80.00%. The drug resistance rates of the E.faecalis and S.aureus to penicillin, oxacillin, erythromycin, gentamicin, and levofloxacin were more than 40.00%. CONCLUSION The pathogens causing the postoperative infections in the curettage patients are highly drug-resistant. It is necessary to conduct the early empirical drug therapy based on clinical experience so as to reasonably use antibiotics.

     

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