宫颈癌患者术后感染病原学特点及耐药性分析

Analysis of etiology and drug resistance of postoperative infections in patients with cervical carcinoma

  • 摘要: 目的 探讨分析宫颈癌术后感染病原学特点及耐药性,为临床治疗提供依据。方法 选择2012年1月-2017年1月期间于医院行宫颈癌根治术的274例宫颈癌患者临床资料,使用全自动细菌检定仪对分离出的病原菌进行菌株鉴定,使用纸片扩散(K-B)法检测病原菌对抗菌药物的耐药情况,观察分析患者术后医院感染病原菌情况及耐药性。结果 274例行宫颈癌根治术患者中发生术后医院感染58例,术后医院感染发生率为21.17%;感染部位主要为泌尿道21例占36.21%、手术切口16例占27.59%;58例医院感染患者中共分离出病原菌86株,其中革兰阴性菌48株占55.81%、革兰阳性菌32株占37.21%、真菌6株占6.98%;主要革兰阴性菌对磺胺甲噁唑/甲氧苄啶、四环素及阿莫西林的耐药率较高,均>80%;粪肠球菌对氯霉素、四环素、利福平的耐药率较高,均≥50%;表皮葡萄球菌对庆大霉素、青霉素G、左氧氟沙星的耐药率较高,均>60%。结论 宫颈癌根治术术后医院感染发生率较高,且病原菌种类复杂,耐药性强,临床治疗应根据药敏试验结果选择合理的抗菌药物,从而提高临床治疗疗效,控制医院感染。

     

    Abstract: OBJECTIVE To investigate the etiological characteristics and drug resistance of postoperative infections in patients with cervical cancer, so as to provide evidence for clinical treatment. METHODS The clinical data of 274 patients with cervical cancer who underwent radical resection of cervical cancer in our hospital from Jan. 2012 to Jan. 2017 were retrospectively analyzed. The isolates were identified by automatic bacterial analyzer, and the resistance of pathogens to antibiotics was detected by disk diffusion (K-B) method. The pathogens and drug resistance of nosocomial infections after operation were observed and analyzed. RESULTS Among 274 patients underwent radical resection of cervical cancer, there were postoperative hospital infections in 58 cases, and the postoperative nosocomial infection rate was 21.17%. The main infection sites were urinary tract and surgical incision, accounting for 36.21% and 27.59%. A total of 86 strains of pathogenic bacteria were isolated from 58 cases of nosocomial infections, including 48 strains of gram-negative bacteria (accounting for 55.81%), 32 strains of gram-positive bacteria (accounting for 37.21%), and 6 strains of fungi (accounting for 6.98%). The resistant rates of main gram-negative bacteria to sulfamethoxazole/trimethoprim, tetracycline and amoxicillin were high, which were more than 80%. The resistant rates of Enterococcus faecalis to chloramphenicol, tetracycline and rifampicin were high, which were higher than 50%. The resistant rates of Staphylococcus epidermidis to gentamicin, penicillin G and levofloxacin were high, which were higher than 60%. CONCLUSION The incidence of nosocomial infections after surgery radical resection of cervical carcinoma is high, and the pathogenic species are complex with strong resistance, so clinical treatment should select rational antimicrobial agents based on the results of drug sensitivity test, so as to improve the curative effect of clinical treatment and control the nosocomial infections.

     

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