2015-2020年新郑市人民医院妇科肿瘤术后患者医院感染的病原菌分布和耐药情况分析

目的 探讨新郑市人民医院妇科肿瘤术后发生医院感染的病原菌情况。方法 选取2015年9月-2020年9月在新郑市人民医院接受妇科肿瘤手术的120例患者的治疗资料进行分析。结果 妇科肿瘤术120例患者总计检出病原菌208株，革兰阴性菌134株（64.42%），革兰阳性菌60株（28.85%），真菌14株（6.73%）。大肠埃希菌耐药性较高的药物依次为头孢曲松（59.09%）、复方新诺明（56.82%）、环丙沙星（54.55%），对替加环素为0。肺炎克雷伯菌耐药性较高的药物依次为阿莫西林（71.42%）、头孢曲松（42.86%）、头孢噻肟（39.29%），最低为替加环素（3.57%）。铜绿假单胞菌耐药性较高的药物依次为头孢曲松（81.25%）、复方新诺明（81.25%）、阿莫西林（68.75%）。鲍氏不动杆菌耐药性较高的药物依次为亚胺培南（100%）、哌拉西林（92.86%）、头孢吡肟（85.71%）。从主要革兰阳性菌对抗菌药物的耐药性来看，金黄色葡萄球菌对氨苄西林（90.00%）、复方新诺明（90.00%）耐药率较高。表皮葡萄球菌对青霉素（81.82%）、四环素（81.82%）耐药率较高。结论 妇科肿瘤手术后感染的发生与多种病原菌有关，主要为革兰阴性菌，不同病原菌的耐药性存在差异，临床治疗方案需要全面评估感染情况，保证用药方案的科学合理，并注重监测，结合病原学证据及时调整治疗方案。

Analysis on the distribution and drug resistance of pathogenic bacteria in patients with nosocomial infection after gynecological tumor surgery in Xinzheng People's Hospital from 2015 to 2020

Objective To investigate the pathogenic bacteria of nosocomial infection after gynecological tumor operation in Xinzheng People''s Hospital. Methods The treatment data of 120 patients undergoing gynecological tumor surgery in Xinzheng People''s Hospital from September 2015 to September 2020 were analyzed. Results A total of 208 strains of pathogenic bacteria were detected from 120 patients undergoing gynecological tumor surgery, including 134 strains of gram-negative bacteria (64.42%), 60 strains of gram-positive bacteria (28.85%), and 14 strains of fungi (6.73%). The drug resistance of Escherichia coli was ceftriaxone (59.09%), cotrimoxazole (56.82%), ciprofloxacin (54.55%), and the drug resistance of tigecycline was 0. The drugs with high drug resistance of Klebsiella pneumonia were amoxicillin (71.42%), ceftriaxone (42.86%), cefotaxime (39.29%), and the lowest was tigecycline (3.57%). The drugs with high resistance to Pseudomonas aeruginosa were ceftriaxone (81.25%), cotrimoxazole (81.25%), and amoxicillin (68.75%). The drugs with high resistance to Acinetobacter baumannii were imipenem (100%), piperacillin (92.86%), and cefepime (85.71%). In terms of antimicrobial resistance of main gram-positive bacteria, Staphylococcus aureus had higher drug resistance rates to ampicillin (90.00%) and cotrimoxazole (90.00%). The resistance rates of Staphylococcus epidermidis to benzylpenicillin (81.82%) and tetracycline (81.82%) were higher. Conclusions The occurrence of infection after gynecological tumor surgery is related to a variety of pathogens, mainly gram-negative bacteria, and there are differences in drug resistance of different pathogens. The clinical treatment plan needs to be comprehensively evaluated to ensure the scientific and reasonable drug use plan, pay attention to monitoring, and adjust the treatment plan in time combined with etiological evidence.