河北医学2023，Vol.29Issue(12)：2077-2083,7.DOI:10.3969/j.issn.1006-6233.2023.12.027
胃肠疾病手术患者术后呼吸道感染的病原菌分布药敏性及影响因素分析
Analysis of Pathogen Distribution,Drug Sensitivity and Influencing Factors of Postoperative Respiratory Tract Infections in Patients with Gastrointestinal Surgery
摘要
Abstract
Objective:To investigate the distribution of pathogens,drug sensitivity,and influencing fac-tors of postoperative respiratory tract infections in patients undergoing gastrointestinal surgery.Methods:A to-tal of 105 patients with postoperative respiratory tract infections after gastrointestinal surgery from April 2019 to April 2023 were selected as the infection group.The distribution and drug sensitivity of pathogens in infected patients were analyzed.Another 105 patients who did not develop respiratory tract infections after gastrointesti-nal surgery during the same period were selected as the non-infection group.General information was collect-ed for both groups,and multifactor logistic regression analysis was used to explore the risk factors for postoper-ative respiratory tract infections in patients undergoing gastrointestinal surgery.Results:In the 105 patients of the infection group,a total of 121 strains of pathogens were isolated from sputum samples.Among them,78 strains(64.46%)were Gram-negative bacteria,mainly Pseudomonas aeruginosa;37 strains(30.58%)were Gram-positive bacteria,mainly Staphylococcus aureus;and 6 strains(4.96%)were fungi,all Candida albi-cans.Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,and Acinetobacter baumannii had a 100%resistance rate to ampicillin.The resistance rates of Pseudomonas aeruginosa,Klebsiella pneumoniae,and Escherichia coli to piperacillin/tazobactam were 6.45%,15.00%,and 7.69%,respectively.Staphylo-coccus aureus,hemolytic Staphylococcus,and Staphylococcus epidermidis had resistance rates of 100.00%,90.00%,and 100.00%to penicillin,respectively.The resistance rates of Staphylococcus aureus,hemolytic Staphylococcus,and Staphylococcus epidermidis to quinupristin/dalfopristin were all 0.00%.There were sta-tistically significant differences between the two groups in terms of age,smoking history,diabetes,history of lung disease,surgical method,surgical nature,surgical time,and gastric tube retention(P<0.05).Binary logistic regression analysis showed that smoking history(OR=1.772,p=0.002),diabetes(OR=2.212,P<0.001),history of lung disease(OR=1.950,P=0.001),open surgery(OR=2.522,P<0.001),emer-gency surgery(OR=2.389,P<0.001),surgery time≥2h(OR=2.102,P=0.002),and gastric tube re-tention(OR=1.857,P<0.001)were all risk factors for postoperative respiratory tract infections in patients undergoing gastrointestinal surgery.Conclusion:Postoperative respiratory tract infections in patients undergo-ing gastrointestinal surgery are mainly caused by Gram-negative bacteria.Gram-negative bacteria have high resistance to ampicillin,and Gram-positive bacteria have high resistance to penicillin.The occurrence of post-operative respiratory tract infections is related to multiple risk factors.关键词
胃肠疾病手术/呼吸道感染/病原菌/药敏性/风险因素Key words
Gastrointestinal surgery/Respiratory tract infection/Pathogen/Drug sensitivity/Risk factors引用本文复制引用
涂秀,张克昌,吴战..胃肠疾病手术患者术后呼吸道感染的病原菌分布药敏性及影响因素分析[J].河北医学,2023,29(12):2077-2083,7.基金项目
2019年安徽省重点研究与开发计划项目,(编号:201904b11020023) （编号:201904b11020023）
