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.	叶慧, 宗志勇, 吕晓菊. 2017 年版美国疾病预防控制中心手术部位感染预防指南解读.中国循证医学杂志, 2017, 17(7): 745-750.
2.	石喜之, 王济峰, 周涌, 等. 手术后切口感染与抗生素合理应用的评价. 第四军医大学学报, 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.	叶应妩, 王毓三, 申子瑜. 全国临床检验操作规程. 3 版. 南京: 东南大学出版社, 2006: 750.
5.	中华人民共和国卫生部. 医院感染诊断标准(试行). 中华医学杂志, 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.	顾红红, 应群芳. 妇产科住院患者医院感染特点及相关因素分析. 中华医院感染学杂志, 2011, 21(6): 1125-1127.
8.	李霈, 袁丽芬, 邓刚. 妇科手术腹部切口感染影响因素及预防对策. 中华医院感染学杂志, 2014, 24(15): 3847-3884.
9.	石娜, 徐卫, 薛利霞, 等. 恶性肿瘤患者医院败血症危险因素的病例对照研究. 中华医院感染学杂志, 2009, 19(11): 1358-1359.
10.	郑媛, 张玲, 焦成元, 等. 外科手术部位感染目标性监测分析. 华西医学, 2014, 29(3): 428-431.
11.	阎玉矿, 刘辉, 李德宁, 等. 糖尿病患者腹部切口感染的临床分析. 中华医院感染学杂志, 2005, 15(8): 870-872.
12.	陈东科, 孙长贵. 实用临床微生物学检验与图谱. 北京: 人民卫生出版社, 2011.
13.	尹美玲, 邓芳, 樊平, 等. 结直肠癌患者手术部位感染的病原学及药敏分析. 临床输血与检验, 2017, 19(4): 386-389.
14.	旷凌寒, 王嘉敏, 周伟, 等. 新生儿科下呼吸道感染病原菌分布及耐药性分析. 华西医学, 2014, 29(3): 417-419.
15.	陈龙, 张淑珍, 耿丽殊, 等. 妇科住院患者医院感染病原菌特点及耐药性分析. 中华医院感染学杂志, 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.	张小红, 罗丽霞. 腹部手术切口感染危险因素调查分析及预防. 南华大学学报: 医学版, 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. 叶慧, 宗志勇, 吕晓菊. 2017 年版美国疾病预防控制中心手术部位感染预防指南解读.中国循证医学杂志, 2017, 17(7): 745-750.
2. 石喜之, 王济峰, 周涌, 等. 手术后切口感染与抗生素合理应用的评价. 第四军医大学学报, 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. 叶应妩, 王毓三, 申子瑜. 全国临床检验操作规程. 3 版. 南京: 东南大学出版社, 2006: 750.
5. 中华人民共和国卫生部. 医院感染诊断标准(试行). 中华医学杂志, 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. 顾红红, 应群芳. 妇产科住院患者医院感染特点及相关因素分析. 中华医院感染学杂志, 2011, 21(6): 1125-1127.
8. 李霈, 袁丽芬, 邓刚. 妇科手术腹部切口感染影响因素及预防对策. 中华医院感染学杂志, 2014, 24(15): 3847-3884.
9. 石娜, 徐卫, 薛利霞, 等. 恶性肿瘤患者医院败血症危险因素的病例对照研究. 中华医院感染学杂志, 2009, 19(11): 1358-1359.
10. 郑媛, 张玲, 焦成元, 等. 外科手术部位感染目标性监测分析. 华西医学, 2014, 29(3): 428-431.
11. 阎玉矿, 刘辉, 李德宁, 等. 糖尿病患者腹部切口感染的临床分析. 中华医院感染学杂志, 2005, 15(8): 870-872.
12. 陈东科, 孙长贵. 实用临床微生物学检验与图谱. 北京: 人民卫生出版社, 2011.
13. 尹美玲, 邓芳, 樊平, 等. 结直肠癌患者手术部位感染的病原学及药敏分析. 临床输血与检验, 2017, 19(4): 386-389.
14. 旷凌寒, 王嘉敏, 周伟, 等. 新生儿科下呼吸道感染病原菌分布及耐药性分析. 华西医学, 2014, 29(3): 417-419.
15. 陈龙, 张淑珍, 耿丽殊, 等. 妇科住院患者医院感染病原菌特点及耐药性分析. 中华医院感染学杂志, 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. 张小红, 罗丽霞. 腹部手术切口感染危险因素调查分析及预防. 南华大学学报: 医学版, 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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