老年宫颈癌患者根治术后感染的病原学特征分析

【目的】分析老年宫颈癌患者根治术后感染的病原学特征。【方法】选取2014年3月至2018年10月在本院接受手术治疗的163例老年宫颈癌患者,分析术后感染发生率、病原学特征及感染危险因素。【结果】术后感染发生率28.22.%(46/163),其中泌尿道感染(43.48%)、手术切口感染(23.91%)和阴道感染(10.87%)排前3位。检出57株病原菌,革兰阴性菌27株(47.39%),革兰阳性菌23株(40.35%),真菌7株(12.28%),检出率排前2位的病原菌分别为大肠埃希菌(21.05%),金黄色葡萄球菌(15.79%)。大肠埃希菌对亚胺培南、利福平和红霉素敏感性高(<10%),对磺胺甲恶唑、哌拉西林、左氧氟沙星和四环素耐药性均在80%以上。金黄色葡萄球菌对亚胺培南敏感性高,耐药率为0,对利福平、青霉素G和左氧氟沙星耐药性均在70%以上,对头孢曲松、四环素和磺胺甲恶唑的耐药性也均在40%以上。单因素和logistics多元回归分析显示:手术时间≥3 h、尿管留置时间≥14 d、抗菌药物使用种类≥3种、术后化疗和贫血是发生术后感染的独立危险因素(P<0.05)。【结论】老年宫颈癌患者根治术后感染发生率较高,主要感染病原菌为大肠埃希菌和金黄色葡萄球菌,且其对临床常见抗菌药物耐药性较高。实际临床工作中应根据耐药性分析结果合理选择抗菌药物,并针对术后感染危险因素采取相关预防措施。

Etiological Characteristics of Infection in Elderly Patients with Cervical Cancer after Radical Resection

【Objective】To analyze the etiological characteristics of infection in elderly patients with cervical cancer after radical resection.【Methods】A total of 163 elderly patients with cervical cancer who underwent surgical resection in Chengdu University Hospital from March 2014 to October 2018 were selected for the study.The incidence of postoperative infection,pathogenic characteristics and risk factors of postoperative infection were analyzed.【Results】The incidence of postoperative infection was 28.22%(46/163),among which urinary tract infection(43.48%),surgical incision infection(23.91%)and vagina infection(10.87%)ranked the top three.A total of 57 pathogenic bacteria were detected,which contained 27 gram-negative bacteria(47.39%),23 gram-positive bacteria(40.35%)and 7 fungi(12.28%).The top two pathogens were Escherichia coli(21.05%)and Staphylococcus aureus(15.79%).The susceptibility of Escherichia coli to imipenem,rifampicin and erythromycin was high(<10%),while the resistance to sulfamethoxazole,piperacillin,levofloxacin and tetracycline was more than 80%.Staphylococcus aureus was highly sensitive to imipenem without any drug resistance while its resistance to rifampin,penicillin G and levofloxacin was more than 70%and resistance to ceftriaxone,tetracycline and sulfamethoxazole was more than 40%.Single factor and logistic Univariate and multivariate logistic regression analysis showed that operation time≥3 h,urinary catheter retention time≥14 d,antibiotics usage≥3 kinds,postoperative chemotherapy and anemia were independent risk factors for postoperative infection(P<0.05).【Conclusion】The incidence of infection is high in the elderly patients with cervical cancer after radical resection.The main pathogens are Escherichia coli and Staphylococcus aureus showing high resistant to common antibiotics.In practical clinical work,antibiotics should be selected reasonably according to the results of drug resistance analysis,so relevant preventive measures should be taken against the risk factors of postoperative infection.