普通外科术后感染病原菌种类及其耐药性剖析.docVIP

普通外科术后感染病原菌种类及其耐药性剖析 　　[摘要] 目的：探讨普通外科术后感染常见菌种分布及其耐药性，为临床诊治提供科学依据。方法：采集普通外科患者术后临床标本，用法国生物梅里埃公司的ATB细菌鉴定系统进行鉴定，并以K-B法进行细菌药敏试验。结果：共采集临床标本386份，病原菌检出率为39.64%。检出的病原菌中G-杆菌占58.82%，主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和嗜麦芽窄食单胞菌；G+球菌占34.64%，以葡萄球菌和肠球菌多见。药敏试验结果显示，G-杆菌对亚胺培南的耐药率普遍较低，为15.79%~33.33%，G+球菌对万古霉素、替考拉宁耐药率均为0。结论：普通外科应加强对术后感染病原菌的检测，根据药敏试验结果合理使用亚胺培南、万古霉素、替考拉宁等进行治疗。 　　[关键词] 普通外科；手术；病原菌；耐药性；药物敏感试验 　　[中图分类号] R63 [文献标识码]B[文章编号]1673-7210（2007）11（c）-074-03 　　 　　Distribution and drug resistance of bacteria isolated from postoperative infections in patients in department of general surgery 　　HUANG Zhi-yong*, GAO Wen-ming, NI Shi-yu, SUN Jing-bo 　　(Department of general surgery, Daqing Oilfield General Hospital Group Longnan Hospital, Daqing163001, China) 　　[Abstract] Objective: To explore the distribution and the drug resistance of bacteria isolated from postoperative infections in patients in department of general surgery, and to provide a scientific evidence for clinical rational administration. Methods:Clinical specimens were collected and identified for pathogenic bacteria with ATB-Expression (Bio Merieux, French), and the drug sensitive tests were performed with K-B method. Results: The total detectable rate of the pathogenic bacteria was 39.64%(153/386). Among the isolated bacteria, 58.82% of them were Gram-negative bacillus including Escherichia coli, Pseudomonas aeruginosa, Klebsiella peneumoniae, and Stenotrophomonas maltophilia; and 34.64% were Gram-positive coccus concerning with Staphylococci and Enterococci. According to drug sensitive test, G-bacteria were sensitive to imipenem, while the G+ bacteria were sensitive to vance and teicoplanin. Conclusion: It is suggested that pathogenic bacteria should be isolated, identified and given drug sensitive tests after operation in department of general surgery, and imipenem, vance and teicoplanin might be used in treatment of postoperative infections. 　　[Key words] General surgery; Operation; Pathogenic bacteria; Drug resistance; D