剖宫产术后产褥感染的病原菌分布及耐药性分析

目的观察剖宫产术后产褥感染患者病原菌的分布特点,并对其耐药性进行分析。方法选择2009年2月至2012年10月在武汉第五医院住院的125例剖宫产术后产褥感染患者作为研究对象,对细菌种类进行鉴定,并对细菌耐的药性予以分析。结果 125例产褥感染患者共检出178株病原菌,其中以大肠埃希菌(87株,48.9%)为主,其次为阴道加德纳菌(48株,27.0%)和链球菌(25株,14.0%)。大肠埃希菌对头孢他啶、阿卡米星和头孢吡肟比较敏感;阴道加德纳菌对阿卡米星、环丙沙星、庆大霉素和复方磺胺甲口恶唑(磺胺甲口恶唑+甲氧苄啶)比较敏感;链球菌对庆大霉素较为敏感。结论剖宫产术后产褥感染的病原菌主要为大肠埃希菌、阴道加德纳菌和链球菌,应尽量行细菌培养及药物敏感性试验,根据药物敏感性试验结果选择适当的抗生素予以治疗。

Analysis on the Pathogens Distribution and Drug-resistance of Puerperal Infection after Cesarean Section

Objective To investigate the distribution of pathogenic bacteria in patients with puerperal infection after cesarean section,and to analyze the drug resistance. Methods A total of 125 patients with puerperal infection after cesarean section admitted in Wuhan Fifth Hospital from Feb. 2009 to Oct. 2012 were selected as the research objects, the bacterial species were identified, and the drug resistance of the bacteria was analyzed. Results A total of 178 strains of pathogenic bacteria were detected among the 125 patients with puerperal infection,which mainly include Escherichia coli（ 87 strains,48.9 % ）, followed by vaginal Gardiner＇s bacteria （48 strains,27.0 % ） and Streptococcus pneumoniae （25 strains, 14. 0% ）. Escherichia coli was sensitive to ceftazidime, cefepime, amikacin. Vaginal Gardiner＇s bacteria was sensitive to amikacin, ciprofloxacin, gentamicin, and compound SMZ （SMZ ＋ trimethoprim）. Streptococcus was sensitive to gentamicin. Conclusion Escherichia coli ,vaginal Gardiner＇s bacteria and Streptococcus were the main pathogen of puerperal infection after cesarean section, timely bacterial culturing and drug sensitive test should be done for the patients, in order to ensure appropriate antibiotic therapy can be applied to the natients accordin~ to the results of drum sensitivitv test.