Distribution and drug resistance of pathogens causing surgical site infection in patients after gynecologic operation_West China Medical Journal

Authors：

OU Yanghua ¹ , CHEN Cen ² , CHEN Jing ³ , ZHOU Wei ¹ , KUANG Linghan ¹ ,  JIANG Yongmei ¹

1. Clinical Laboratory Department, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects andRelated Diseases of Women and Children, Sichuan University, Ministry of Education; Chengdu, Sichuan 610041, P. R. China;
2. Department of Obstetrics and Gynecology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, P. R. China;
3. Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects andRelated Diseases of Women and Children, Sichuan University, Ministry of Education; Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

JIANG Yongmei, Email: jiangyongmei-1@163.com

Keywords：

Gynecologic operation; Surgical site infection; Pathogen; Drug susceptibility test

DOI：

10.7507/1002-0179.201801189

Video：

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Objective To probe the distribution and drug resistance of pathogens causing surgical site infection in patients after gynecologic operation, and provide reference for prevention and treatment. Methods Seventy patients with incision infection after gynecologic operation in West China Second University Hospital of Sichuan University from January 2010 to May 2015 were selected. Species of the pathogens from the submitted specimens and the results of the drug susceptibility testing were analyzed. Results Seventy-two strains of pathogens were isolated, including 36 strains (50.0%) of Gram-negative (G^–) bacteria and 36 strains (50.0%) of Gram-positive (G⁺) bacteria. The main G^– bacteria were Escherichia coli (36.1%) and Enterobacter cloacae (5.6%); the main G⁺ bacteria were Staphylococcus aureus (18.1%), Staphylococcus epidermidis (12.5%), and Enterococcus faecalis (8.3%). Escherichia coli showed low sensitivities to ampicillin, ceftriaxone, and gentamicin, with resistance rates of 76.9%, 61.5%, and 61.5%, respectively. Staphylococcus aureus showed low sensitivities to penicillin G, clindamycin, and erythromycin, with resistance rates of 92.3%, 69.2%, and 61.5%, respectively. Staphylococcus epidermidis showed low sensitivities to erythromycin, penicillin G, and ciprofloxacin, with resistance rates of 88.9%, 77.8%, and 77.8%, respectively. No carbapenem-resistant G^– bacteria or vancomycin-resistant G⁺ bacteria were detected. Conclusion Postoperative surgical site infection is the most common nosocomial infection. The main bacteria related to postoperative incision infection in the gynecology department of the hospital are Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, and Enterococcus faecalis, which become resistant to common antibiotics currently. Therefore more attention should be paid to bacterial isolation and drug susceptibility test results for rational use of antimicrobial drugs and effectiveness of the treatment to nosocomial infection.

Citation： OU Yanghua, CHEN Cen, CHEN Jing, ZHOU Wei, KUANG Linghan, JIANG Yongmei. Distribution and drug resistance of pathogens causing surgical site infection in patients after gynecologic operation. West China Medical Journal, 2018, 33(3): 294-297. doi: 10.7507/1002-0179.201801189 Copy

1.	葉慧, 宗志勇, 呂曉菊. 2017 年版美國疾病預防控制中心手術部位感染預防指南解讀.中國循證醫學雜志, 2017, 17(7): 745-750.
2.	石喜之, 王濟峰, 周涌, 等. 手術后切口感染與抗生素合理應用的評價. 第四軍醫大學學報, 2012, 21(27): 897-898.
3.	Talbot TR. Diabetes mellitus and cardiothoracic surgical site infections. Am J Infect Control, 2005, 33(6): 353-359.
4.	葉應嫵, 王毓三, 申子瑜. 全國臨床檢驗操作規程. 3 版. 南京: 東南大學出版社, 2006: 750.
5.	中華人民共和國衛生部. 醫院感染診斷標準(試行). 中華醫學雜志, 2001, 81(5): 314-320.
6.	Clinical and Laboratory Standards Institute. M100-S24: performance standards for antimicrobial susceptibility testing; 24th informational supplement. (2014-02-23)[2017-12-12]. http://www.gxccl.com/download/upload/CLSIM100-S24%E8%8B%B1%E6%96%87%E7%89%88.pdf.
7.	顧紅紅, 應群芳. 婦產科住院患者醫院感染特點及相關因素分析. 中華醫院感染學雜志, 2011, 21(6): 1125-1127.
8.	李霈, 袁麗芬, 鄧剛. 婦科手術腹部切口感染影響因素及預防對策. 中華醫院感染學雜志, 2014, 24(15): 3847-3884.
9.	石娜, 徐衛, 薛利霞, 等. 惡性腫瘤患者醫院敗血癥危險因素的病例對照研究. 中華醫院感染學雜志, 2009, 19(11): 1358-1359.
10.	鄭媛, 張玲, 焦成元, 等. 外科手術部位感染目標性監測分析. 華西醫學, 2014, 29(3): 428-431.
11.	閻玉礦, 劉輝, 李德寧, 等. 糖尿病患者腹部切口感染的臨床分析. 中華醫院感染學雜志, 2005, 15(8): 870-872.
12.	陳東科, 孫長貴. 實用臨床微生物學檢驗與圖譜. 北京: 人民衛生出版社, 2011.
13.	尹美玲, 鄧芳, 樊平, 等. 結直腸癌患者手術部位感染的病原學及藥敏分析. 臨床輸血與檢驗, 2017, 19(4): 386-389.
14.	曠凌寒, 王嘉敏, 周偉, 等. 新生兒科下呼吸道感染病原菌分布及耐藥性分析. 華西醫學, 2014, 29(3): 417-419.
15.	陳龍, 張淑珍, 耿麗殊, 等. 婦科住院患者醫院感染病原菌特點及耐藥性分析. 中華醫院感染學雜志, 2010, 20(16): 2494-2495.
16.	Tuuli MG, Rampersad RM, Carbone JF, et al. Staples compared with subcuticular suture for skin closure after cesarean delivery: a systematic review and meta-analysis. Obstet Gynecol, 2011, 117(3): 682-690.
17.	張小紅, 羅麗霞. 腹部手術切口感染危險因素調查分析及預防. 南華大學學報: 醫學版, 2010, 38(2): 301-302.
18.	Sutkin G, Alperin M, Meyn L, et al. Symptomatic urinary tract infections after surgery for prolapse and/or incontinence. Int Urogynecol J, 2010, 21(8): 955-961.

1. 葉慧, 宗志勇, 呂曉菊. 2017 年版美國疾病預防控制中心手術部位感染預防指南解讀.中國循證醫學雜志, 2017, 17(7): 745-750.
2. 石喜之, 王濟峰, 周涌, 等. 手術后切口感染與抗生素合理應用的評價. 第四軍醫大學學報, 2012, 21(27): 897-898.
3. Talbot TR. Diabetes mellitus and cardiothoracic surgical site infections. Am J Infect Control, 2005, 33(6): 353-359.
4. 葉應嫵, 王毓三, 申子瑜. 全國臨床檢驗操作規程. 3 版. 南京: 東南大學出版社, 2006: 750.
5. 中華人民共和國衛生部. 醫院感染診斷標準(試行). 中華醫學雜志, 2001, 81(5): 314-320.
6. Clinical and Laboratory Standards Institute. M100-S24: performance standards for antimicrobial susceptibility testing; 24th informational supplement. (2014-02-23)[2017-12-12]. http://www.gxccl.com/download/upload/CLSIM100-S24%E8%8B%B1%E6%96%87%E7%89%88.pdf.
7. 顧紅紅, 應群芳. 婦產科住院患者醫院感染特點及相關因素分析. 中華醫院感染學雜志, 2011, 21(6): 1125-1127.
8. 李霈, 袁麗芬, 鄧剛. 婦科手術腹部切口感染影響因素及預防對策. 中華醫院感染學雜志, 2014, 24(15): 3847-3884.
9. 石娜, 徐衛, 薛利霞, 等. 惡性腫瘤患者醫院敗血癥危險因素的病例對照研究. 中華醫院感染學雜志, 2009, 19(11): 1358-1359.
10. 鄭媛, 張玲, 焦成元, 等. 外科手術部位感染目標性監測分析. 華西醫學, 2014, 29(3): 428-431.
11. 閻玉礦, 劉輝, 李德寧, 等. 糖尿病患者腹部切口感染的臨床分析. 中華醫院感染學雜志, 2005, 15(8): 870-872.
12. 陳東科, 孫長貴. 實用臨床微生物學檢驗與圖譜. 北京: 人民衛生出版社, 2011.
13. 尹美玲, 鄧芳, 樊平, 等. 結直腸癌患者手術部位感染的病原學及藥敏分析. 臨床輸血與檢驗, 2017, 19(4): 386-389.
14. 曠凌寒, 王嘉敏, 周偉, 等. 新生兒科下呼吸道感染病原菌分布及耐藥性分析. 華西醫學, 2014, 29(3): 417-419.
15. 陳龍, 張淑珍, 耿麗殊, 等. 婦科住院患者醫院感染病原菌特點及耐藥性分析. 中華醫院感染學雜志, 2010, 20(16): 2494-2495.
16. Tuuli MG, Rampersad RM, Carbone JF, et al. Staples compared with subcuticular suture for skin closure after cesarean delivery: a systematic review and meta-analysis. Obstet Gynecol, 2011, 117(3): 682-690.
17. 張小紅, 羅麗霞. 腹部手術切口感染危險因素調查分析及預防. 南華大學學報: 醫學版, 2010, 38(2): 301-302.
18. Sutkin G, Alperin M, Meyn L, et al. Symptomatic urinary tract infections after surgery for prolapse and/or incontinence. Int Urogynecol J, 2010, 21(8): 955-961.

West China Medical Journal

Distribution and drug resistance of pathogens causing surgical site infection in patients after gynecologic operation

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