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目的探讨急性阑尾炎患儿术后切口感染病原菌分布及耐药性,为临床有效治疗阑尾炎术后切口感染提供理论依据。方法选取医院2012年10月-2015年10月收治597例急性阑尾炎患儿为研究对象,统计分析其术后切口感染率、感染病原菌分布及药敏试验结果,数据采用SPSS 19.0软件进行统计处理。结果 597例急性阑尾炎患儿术后切口感染52例,感染率为8.71%;共培养出病原菌68株,其中革兰阴性菌42株占67.76%,革兰阳性菌26株占38.24%;大肠埃希菌对阿莫西林的耐药率最高为56.25%,肺炎克雷伯菌对庆大霉素的耐药率最高为100.00%,铜绿假单孢菌对头孢他定的耐药率最高为91.67%;金黄色葡萄球菌对头孢曲松的耐药率最高为55.56%,粪肠球菌对克林霉素和四环素的耐药率较高均为80.00%;凝固酶阴性葡萄球菌对克林霉素、四环素的耐药率均为80.00%。结论导致急性阑尾炎患儿术后切口感染的病原菌主要为革兰阴性菌,其次为革兰阳性菌,其对常用抗菌药物的耐药性较高,因此,加强抗菌药物监管、防止抗菌药物滥用,针对性地合理选择抗菌药物治疗,可以提高患者治疗效果和生活质量,值得引起临床重视。
Objective To investigate the distribution and drug resistance of incisional wound infection in children with acute appendicitis and provide a theoretical basis for clinical effective treatment of incisional infection after appendicitis. Methods A total of 597 children with acute appendicitis were selected from October 2012 to October 2015 in our hospital. The incidence of incision infection, the distribution of pathogenic bacteria and drug susceptibility test results were statistically analyzed. The data were analyzed by SPSS 19.0 software. Results In 597 cases of acute appendicitis, 52 cases were incisional wound infection with an infection rate of 8.71%. 68 strains of pathogens were co-cultured, of which 42 strains were gram-negative bacteria, 67.76% and 26 strains were gram-positive bacteria, accounting for 38.24% The highest rate of resistance to amoxicillin was 56.25%, the highest rate of resistance to gentamycin was 100.00% in Klebsiella pneumoniae, and the highest rate of resistance to ceftazidime was 91.67 %; Staphylococcus aureus resistant rate to ceftriaxone is the highest 55.56%, Enterococcus faecalis to clindamycin and tetracycline resistance rates were 80.00%; coagulase-negative Staphylococcus aureus clindamycin , Tetracycline resistance rates were 80.00%. Conclusions The pathogenic bacteria of incisional wound infection in children with acute appendicitis are Gram-negative bacteria, followed by Gram-positive bacteria, which have higher resistance to commonly used antibiotics. Therefore, we should strengthen the supervision of antibiotics, prevent the abuse of antibiotics, Targeted rational choice of antimicrobial treatment, can improve patient outcomes and quality of life, it is worth drawing clinical attention.