宫颈癌根治术后泌尿系统感染患者的病原菌分布及耐药性分析

Distribution and sensitivity of pathogenic bacteria in urinary system infection after radical operation of cervical cancer

  • 摘要: 目的 分析宫颈癌根治术后泌尿道感染患者的病原菌分布及耐药性,为医院感染预防控制工作提供客观依据。方法 选取2013年3月-2016年8月314例行宫颈癌根治术患者为研究对象,对其术后泌尿系统感染病原菌分布及耐药性进行观察和分析。结果 314例行宫颈癌根治术患者中112例发生尿道感染,感染率为35.7%;共检出202株病原菌,其中革兰阴性菌、革兰阳性菌、真菌分别占61.0%、33.6%和5.4%,主要病原菌为大肠埃希菌、粪肠球菌、肺炎克雷伯菌、阴沟肠杆菌,分别占31.7%、15.3%、14.4%、10.9%;革兰阴性菌中大肠埃希菌对氨苄西林、左氧氟沙星、四环素、磺胺甲噁唑/甲氧苄啶、环丙沙星等耐药率较高,均>85.0%,肺炎克雷伯菌对氨苄西林、呋喃妥因的耐药率较高,均>60.0%,阴沟肠杆菌对氨苄西林、阿莫西林、头孢唑林等耐药率均为100.0%;未检出耐亚胺培南革兰阴性菌;革兰阳性菌中粪肠球菌对红霉素、四环素、利福平、氯霉素的耐药率较高,均>50.0%,表皮葡萄球菌对青霉素G、左氧氟沙星、庆大霉素的耐药率较高,均>75.0%,屎肠球菌对左氧氟沙星、呋喃妥因、氨苄西林、四环素等耐药率较高,均>75.0%,未检出耐万古霉素革兰阳性菌。结论 宫颈癌根治术后泌尿系统感染的病原菌分布和耐药性均具有一定的特征,临床医师应对其给予高度重视、密切监控和有效干预,以提高医院感染预防控制效果。

     

    Abstract: OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria in urinary system infection after radical operation of cervical cancer, so as to provide objective evidence for the prevention and control of hospital infection. METHODS A total of 314 patients underwent radical operation of cervical cancer from Mar. 2013 to Aug. 2016 were selected as the research objects. The distribution and drug resistance of pathogenic bacteria in urinary system infection after operation of the patients were observed and analyzed. RESULTS The pathogenic bacteria were detected in urine samples of 112 patients, and the infection rate was 35.7%. Totally 202 strains of bacteria were detected, in which gram-negative bacteria, gram-positive bacteria and fungi accounted for 60.9%, 33.7% and 5.4%,respectively. The main pathogens were Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae, and Enterobacter cloacae, accounting for 31.7%, 15.3%, 14.4%, and 10.9%, respectively. In gram-negative bacteria, the resistant rates of Escherichia coli to ampicillin, levofloxacin, tetracycline, sulfamethoxazole/trimethoprim, and ciprofloxacin were higher and more than 85%. In gram-positive bacteria, the resistant rates of K. pneumoniae to ampicillin and nitrofurantion were higher and more than 60%. The resistant rates of Enterobacter cloacae to ampicillin, amoxicillin and cefazolin were 100.0%. No gram-negative pathogens resistant to imipenem were detected. The resistant rates of Enterococcus faecium to erythromycin, tetracycline , rifampicin, and chloramphenicol were higher and more than 50%. The resistant rates of Staphylococcus aureus to penicillin G, levofloxacin, and gentamicin were higher and more than 75%. The resistant rates of Enterococcus faecium to levofloxacin, nitrofurantoin, ampicillin and tetracycline were higher and more than 75%. No gram-positive pathogens resistant to vancomycin were detected. CONCLUSION The distribution and drug resistance of pathogenic bacteria in urinary system infection after radical operation of cervical cancer has certain characteristics. The clinicians should give high attention, close monitoring and effective intervention in order to improve the effects of prevention and control of nosocomial infection.

     

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