|本期目录/Table of Contents|

[1]潘 娟,孙小君,王治英.肛周脓肿患者术后多重耐药菌感染特点及危险因素分析[J].传染病信息,2019,03:242-245.
 PAN Juan,SUN Xiao-jun*,WANG Zhi-ying.Analysis on characteristics and risk factors of multidrug-resistantbacteria infection in patients with perianal abscess after operation[J].Infectious Disease Information,2019,03:242-245.
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肛周脓肿患者术后多重耐药菌感染特点及危险因素分析(PDF)

《传染病信息》[ISSN:1007-8134/CN:11-3886/R]

期数:
2019年03期
页码:
242-245
栏目:
论 著
出版日期:
2019-07-12

文章信息/Info

Title:
Analysis on characteristics and risk factors of multidrug-resistantbacteria infection in patients with perianal abscess after operation
文章编号:
   1007-8134(2019)03-0242-04
作者:
潘 娟孙小君王治英
810000 西宁,青海省中医院供应室(潘娟、王治英), 肛肠科(孙小君)
Author(s):
PAN Juan SUN Xiao-jun* WANG Zhi-ying
Supplies Room, Qinghai Provincial Hospital of Traditional Chinese Medicine, Xining 810000, China
关键词:
肛周脓肿多重耐药菌感染危险因素  
Keywords:
perianal abscess multiple drug-resistant bacteria infection risk factors
分类号:
R446.5    
DOI:
10.3969/j.issn.1007-8134.2019.03.012
文献标识码:
A
摘要:
目的 探讨肛周脓肿患者术后多重耐药菌感染特点及危险因素。方法 选取我院 2016年 3月—2018年 3月期间收治的肛周脓肿患者 117例为研究对象,均行肛周脓肿切开根治术治疗。于患者切口病变区,清除自然流出的脓液,以无菌棉拭子从脓肿深部取样培养并分离鉴定病原菌,药物敏感(药敏)试验采用纸片扩散法。观察术后多重耐药菌感染情况,收集患者性别、年龄、吸烟史、合并高血压、合并糖尿病、腹泻史、预防性使用抗菌药物、抗菌药物疗程、使用多种抗菌药等资料,探讨术后多重耐药菌感染的危险因素。结果 117例患者中,发生术后多重耐药菌感染 38例(32.5%),未发生术后多重耐药菌感染 79例(67.5%)。术后多重耐药菌感染患者中,分离出病原菌 47株。分离出的多重耐药菌中,前 3位分别为大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌,分别为 14株、11株、8株。其中,大肠埃希菌对头孢曲松、头孢哌酮和头孢他啶耐药率较高,分别为 92.86%、85.71%和 64.29%;铜绿假单胞菌对头孢曲松、头孢哌酮和头孢他啶耐药率较高,分别为 100%、81.82%和 63.64%;金黄色葡萄球菌对青霉素 G和红霉素耐药率较高,分别为 87.50%和 75.00%。Logistic回归分析显示,合并糖尿病、预防性使用抗菌药物和使用多种抗菌药为术后多重耐药菌感染的危险因素。结论 肛周脓肿患者术后多重耐药菌感染中,以大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌为主,合并糖尿病、预防性使用抗菌药物和使用多种抗菌药为影响术后多重耐药菌感染的危险因素。为降低多重耐药菌感染,应严格按照药敏试验结果合理应用抗菌药物,按照影响因素采取针对性预防措施。  
Abstract:
Objective To investigate the characteristics and risk factors of multidrug-resistant bacteria infection in patients with perianal abscess after operation. Methods One hundred and seventeen patients with perianal abscess who were admitted to our hospital from March 2016 to March 2018 were selected and treated by radical incision operation of perianal abscess. In the patient’s incision lesion area, the natural outflow of pus was cleared, and the bacteria in the deep part of the abscess were collected using sterile cotton swabsfor culture. The pathogenic bacteria were separated and identified with automatic microorganism analyzer. The drug resistance test wascarried out by the paper disc diffusion method. The postoperative multidrug-resistant bacteria infection was observed. The data including sex, age, smoking history, combined hypertension, combined diabetes, diarrhea history, preventive use of antibiotics, treatment course ofantibacterial agents and use of several antibiotics were investigated. The risk factors of multidrug-resistant bacteria infection after operation were analyzed. Results Among the 117 patients, 38 (32.5%) cases appeared multidrug-resistant bacteria infection after operation, and79 (67.5%) cases did not appear multidrug-resistant bacteria infection. Among 38 infected cases, 47 strains of pathogens were screened.The first three isolates were Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus, accounting for 14 strains, 11 strains and 8 strains, respectively. Among the main multidrug resistant bacteria, the resistance rates of Escherichia coli to ceftriaxone, cefoperazoneand ceftazidime were high, accounting for 92.86%, 85.71% and 64.29%, respectively. The resistance rates of Pseudomonas aeruginosato ceftriaxone, cefoperazone and ceftazidime were high, accounting for 100%, 81.82% and 63.64%, respectively. The resistance rates ofStaphylococcus aureus to penicillin G and erythromycin were high, accounting for 87.50% and 75.00% respectively. Logistic regressionanalysis showed that combined diabetes, prophylactic use of antibiotics and the use of several antibiotics were risk factors for multidrug-resistant bacterial infection after operation. Conclusions Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus are dominant strains of multidrug-resistant bacteria in patients with perianal abscess after operation. The combined diabetes, preventive use of antibiotics and the use of several antibiotics are independent risk factors for multidrug-resistant bacteria infection after operation. In order to reduce multidrug-resistant bacteria infection, rational use of antibiotics should be applied in strict accordance with the drug sensitivity test, and targeted preventive measures should be taken according to the influencing factors.       

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备注/Memo

备注/Memo:
[作者单位] 810000 西宁,青海省中医院供应室(潘娟、王治英), 肛肠科(孙小君)
[通信作者] 孙小君,E-mail: doctor_df@126.com
更新日期/Last Update: 2019-07-12