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目的对胃癌患者行根治性切除术后腹腔感染的病原学特征进行回顾性分析。方法回顾性分析479例胃癌患者根治术后腹腔感染的病原学种类及药敏结果。结果 479例患者中32例术后出现腹腔感染(6.68%),病原学阳性者27例,阳性率为84.38%。检出病原菌32株,其中革兰阴性菌24株(75.00%),包括大肠埃希菌15株(46.86%),肺炎克雷伯菌3株(9.38%),普通变形杆菌、奇异变形杆菌、阴沟肠杆菌、普城沙雷菌、不动杆菌及铜绿假单胞菌各1株(各占3.13%);革兰阳性菌7株(21.88%),包括粪肠球菌4株(12.50%),耐久肠球菌、金黄色葡萄球菌及溶血性葡萄球菌各1株(3.13%);真菌1株(3.13%)。药敏结果显示32株病原菌中,对常用抗菌药物的耐药率较高,其中革兰阴性菌对美洛培南敏感性最高(91.67%),而革兰阳性菌对万古霉素最为敏感(85.71%)。结论大肠埃希菌、粪肠球菌、肺炎克雷伯菌是胃癌患者根治术后腹腔感染最主要的致病菌,临床上应注意合理使用抗菌药物。
Objective To retrospectively analyze the etiological features of patients with gastric cancer after radical resection of abdominal infection. Methods A retrospective analysis of 479 cases of gastric cancer patients with postoperative abdominal infection etiology and susceptibility results. Results Among the 479 patients, 32 cases had intraperitoneal infection (6.68%) and 27 cases were positive for etiology. The positive rate was 84.38%. Thirty-two strains of pathogens were detected, of which 24 were Gram-negative bacteria (75.00%), including 15 strains of Escherichia coli (46.86%), 3 strains of Klebsiella pneumoniae (9.38%), Proteus vulgaris, Proteus mirabilis, Enterobacter cloacae, Serratia marcescens, Acinetobacter and Pseudomonas aeruginosa strains (each accounting for 3.13%); Gram-positive bacteria 7 strains (21.88%) including 4 Enterococcus faecalis strains (12.50% , Enterococcus faecalis, Staphylococcus aureus and Staphylococcus aureus (3.13%) and 1 strain (3.13%) respectively. The results of drug susceptibility showed that among the 32 pathogens, the resistance rate to common antibacterials was high, of which gram-negative bacteria had the highest sensitivity to meropenem (91.67%), while gram-positive bacteria were the most sensitive to vancomycin 85.71%). Conclusions Escherichia coli, Enterococcus faecalis and Klebsiella pneumoniae are the most important pathogenic bacteria in patients with gastric cancer after radical operation, and should pay attention to the rational use of antibiotics in clinic.