普外科切口感染病原菌及细菌耐药性分析

目的探讨普外科切口感染菌分布及耐药性,指导临床用药及预防控制措施。方法总结分析本院2003年1月至2005年5月普外科124例切口感染住院患者的病原菌资料。结果124例切口感染标本中共分离出感染菌127株,病原菌依次为:大肠埃希菌占47.24%、肠球菌占18.90%、金黄色葡萄球菌占12.60%、肠杆菌属占7.87%、真菌占7.09%、克雷伯菌属占6.30%。以革兰阴性菌为主占61.41%,革兰阳性菌占31.50%,真菌占7.09%。大肠埃希菌与克雷伯菌的耐药性相仿,对哌拉西林/他唑巴坦、头孢西丁、头孢吡肟、亚胺硫霉素、阿米卡星的耐药率较低,肠杆菌属仅对亚胺硫霉素和阿米卡星的耐药率低,肠球菌仅对万古霉素的耐药率低,金黄色葡萄球菌MRSA检出率为25%,除对青霉素和氨苄青霉素的耐药率较高外,对其它抗菌药物的耐药率尚处于低水平。结论细菌耐药性是引起术后感染、治愈困难的重要原因之一,加强细菌耐药性监测,采用合理预防控制措施,能减低术后切口感染的发生。

The study of distribution and antibacterial agents resistance of microorganism in general surgical site infection

Objective To investigate the distribution and resistance of antibacterial agents of microorganism in general surgical site infection,so as to prevent and control it effectively.Method 124 infection of surgery incisions from January 2003 to May 2006 were analyzed retrospectively.Results 127 strains were isolated from 124 patients.The dominating microorganism were Escherichia coli(47.24%),Enterococcus spp(18.90%),Staphylococcus aureus(12.60%),Enterobacter(7.87%),Fungi(7.09%),Klebsiella(6.30%).Escherichia coli sresistance of antibacterial agents was similiar to Klebsiella.They remained lower antibacterial agents resistance to Piperacilin/tazo,Cefoxitin,Cefepime,Imipenem and Amikacin,Enterobacter only had lower antibcterial agents resistance to Imipenem and Amikacin,Enterococcus spp only had lower antibacterial agents resistance to Vancomycin,MRSA take up 25% in all Staphylococcus aureus.Staphylococcus aureus in this test had lower antibacterial agents resistance to other antibacterial agents,except Penicillin and Ampicilin,Conclusions The antibacterial agents resistance is a important cause in surgical site infection.The infection of surgical site can be controlled by the surveillance of antibacterial agents resistant and use effective prevention and contron step.