胸外科围手术期抗生素的规范使用与术后感染病原菌耐药性分析

目的探讨胸外科围手术期抗生素的规范使用与术后感染病原菌耐药性。方法选取医院胸外科手术执行预防用药规范后6个月住院并接受手术治疗的52例患者作为观察组,另选取规范执行前1年同期(2017年6月-2017年12月)的52例患者作为对照组,采用t检验和χ2检验,比较两组围手术期抗生素使用情况、住院治疗时间,患者用药后炎症因子改善情况及用药不良反应情况。分析胸外科术后感染口感染病原菌分布及耐药性。结果观察组抗生素使用时间(35.14±6.28)h、住院时间(9.27±1.35)d、抗生素费用(1352.37±245.69)元,均低于对照组(t=6.756, 6.176, 18.061,P<0.001);两组术后各炎性因子水平均出现明显升高,但观察组术后hs-CRP、IL-6等炎性因子水平均低于对照组(t=8.667, 23.992, 12.478, P<0.001);观察组并发症发生率为7.69%,低于对照组的23.08%;差异有统计学意义(χ2=4.727,P<0.05)。两组患者共发生术后感染16例,共培养出20株病原菌,常见病原菌有金黄色葡萄球菌、凝固酶阴性葡萄球菌、肺...

Standardized use of antibiotics in perioperative period of thoracic surgery and analysis of drug resistance of postoperative infection pathogens

The aim of this study was to investigate the standard use of antibiotics in perioperative period of thoracic surgery and the drug resistance of postoperative infection pathogens. Methods A total of 52 patients, who received standard surgery guidance for 6 months, hospitalized and underwent thoracic surgery in our hospital, were chosen as observation group. 52 patients were used as the control group. The perioperative antibiotic use, hospitalization time,improvement of inflammatory factors and adverse drug reactions were compared between the two groups. The distribution resistance of pathogenic bacteria infected with oral infection after thoracic surgery was analyzed. Results The antibiotic use time(35.14+6.28) h, hospitalization time(9.27+1.35) days, antibiotic cost(1352.37+245.69) yuan in the observation group were lower than those in the control group(t=6.756, 6.176, 18.061, P<0.001). The levels of inflammatory factors in the two groups increased significantly after operation, but the levels of hs-CRP and IL-6 in the observation group were lower than those in the control group(t=8.667, 23.992, 12.478, P<0.001). The incidence of complications in the observation group was 7.69%, lower than that in the control group(23.08%). The difference was statistically significant(χ2=4.727, P<0.05). A total of 16 cases of postoperative infection occurred in the two groups, and 20 pathogens were cultured. The common pathogens were Staphylococcus aureus, coagulase-negative staphylococci, Klebsiella pneumoniae and Acinetobacter baumannii. Coagulase-negative staphylococci and Staphylococcus aureus were sensitive to vancomycin, and resistant bacteria to penicillin G and amoxicillin were more than 70%. Klebsiella pneumoniae and Acinetobacter baumannii were all imipenem sensitive, and highly resistant to ceftriaxone, cefoperazone, and cefazolin. Conclusion The implementation of antibiotic standard management during the perioperative period of thoracic surgery could effectively control the postoperative inflammatory factor level and the incidence of postoperative infection. For the drug resistance of postoperative infection pathogens, antibiotics should be rationally selected to improve anti-infective treatment and reduce the risk of developing resistant strains.