摘要
目的分析孕妇产后感染的病原菌分布及耐药性,为抗感染治疗工作提供研究依据。方法选取2012年10月-2017年10月的38例产后感染产妇作为研究对象,对其一般资料、感染部位、感染相关样本检出病原菌分布及耐药性进行分析。结果 38例产后感染产妇,以剖宫产产妇、初产产妇居多,合并妊娠期糖尿病、妊娠期高血压孕妇比例分别为31.58%和26.32%,有23.68%的孕妇于产前出现胎膜早破;孕妇产后感染部位以生殖道或子宫感染为主,占42.11%。38例感染产妇共检出46株病原菌,革兰阴性菌24株占52.17%,革兰阳性菌20株占43.48%,真菌2株占4.35%,大肠埃希菌、粪肠球菌、肺炎克雷伯菌、B型链球菌为主要病原菌。革兰阴性菌对氨苄西林、头孢唑林、氨苄西林/舒巴坦、头孢呋辛的耐药率较高,对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、阿米卡星、妥布霉素的耐药率较低,未检出对亚胺培南和美罗培南耐药的菌株。革兰阳性菌对红霉素、四环素、青霉素的耐药率较高,对替加环素、莫西沙星的耐药率较低,未检出对万古霉素和利奈唑胺耐药的菌株。结论孕妇产后感染的病原菌分布和耐药性均具有一定的特征,临床医师应对病原菌的变迁给予密切的监控,根据其耐药性特点选用敏感性抗菌药物进行抗感染治疗。
OBJECTIVE To investigate the distribution and drug resistance of pathogens causing the postpartum infection so as to provide guidance for treatment of the infection.METHODS A total of 38 pregnant women with postpartum infection who were treated in the hospital from Oct 2012 to Oct 2017 were recruited as the study objects.The baseline data of the patients,infection sites,and distribution and drug resistance of the pathogens isolated from infection-related specimens were observed.RESULTS Among the 38 pregnant women with postpartum infection,the pregnant women who were primipara and underwent cesarean section were dominant;the pregnant women who were complicated with gestational diabetes mellitus accounted for 31.58%,and the pregnant women who were complicated with gestational hypertension accounted for 26.32%.The pregnant women who had premature rupture of fetal membrane before the delivery accounted for 23.68%.The pregnant women who had genital tract infection or uterine infection were dominant among the pregnant women with postpartum infection,accounting for 42.11%.Totally 46 strains of pathogens were isolated from the 38 pregnant women with infection,24(52.17%)of which were gram-negative bacteria,20(43.48%)were gram-positive bacteria,and 2(4.35%)were fungi.Escherichia coli,Enterococcus faecalis,Klebsiella pneumoniae and group B Streptococcus were the major species of pathogens.The gram-negative bacteria were highly resistant to ampicillin,cefazolin,ampicillin-sulbactam and cefuroxime,while the drug resistance rates of the strains to piperacillin-tazobactam,cefoperazone-sulbactam,amikacin and tobramycin were low,and no strains were found resistant to imipenem or meropenem.The drug resistance rates of the gram-positive bacteria to erythromycin,tetracycline and penicillin were high,while the drug resistance rates to tigecycline and moxifloxacin were low,and no strains were found resistant to vancomycin or linezolid.CONCLUSIONThe distribution and drug resistance of the pathogens causing the postpartum infection show certain characteristics.It is necessary for clinicians to attach great importance to the monitoring of variation of pathogens and use antibiotics based on the result of the drug susceptibility testing.
作者
肖静
周倩
杨湘妹
游丽萍
钟菊芳
XIAO Jing;ZHOU Qian;YANG Xiang-mei;YOU Li-ping;ZHONG Ju-fang(Wuhan Children's Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology ,Wuhan ,Hubei 430015,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第1期131-134,共4页
Chinese Journal of Nosocomiology
基金
湖北省卫计厅基金资助项目(WJ2015MB248)
关键词
孕妇
产后感染
病原菌分布
耐药性分析
Pregnant woman
Postpartum infection
Distribution of pathogen
Drug resistance
